WO2013025963A2

WO2013025963A2 - Conversion of somatic cells into functional spinal motor neurons, and methods and uses thereof

Info

Publication number: WO2013025963A2
Application number: PCT/US2012/051264
Authority: WO
Inventors: Kevin Carl Eggan; Clifford J. Woolf; Brian J. WAINGER; Justin K. ICHIDA; Esther Yesde SON
Original assignee: President And Fellows Of Harvard College; Children's Medical Center Corporation
Priority date: 2011-08-17
Filing date: 2012-08-17
Publication date: 2013-02-21
Also published as: US20150023927A1; WO2013025963A3; US9770471B2

Abstract

The present invention provides methods of transdifferentiation of somatic cells, for example, directly converting a somatic cell of a first cell type, e.g., a fibroblast into a somatic cell of a second cell type, are described herein. In particular, the present invention generally relates to methods for converting a somatic cell, e.g., a fibroblast into a motor neuron, e.g., an induced motor neuron (iMN) with characteristics of a typical motor neuron. The present invention also relates to an isolated population comprising induced motor neurons (iMNs), compositions and their use in the treatment of motor neuron diseases such as ALS and SMA. In particular, the present invention relates to direct conversion of a somatic cell to an induced motor neuron (iMN) having motor neuron characteristics by increasing the protein expression of at least three motor-neuron inducing (MN-inducing) factors selected from Lhx3, Ascl1, Brn2, Myt1l, Isl1, Hb9, Ngn2 or NeuroD1 in a somatic cell, e.g., a fibroblast to convert the fibroblast to an induced motor neuron (iMN) which exhibits at least two characteristics of an endogenous motor neuron.

Description

CONVERSION OF SOMATIC CELLS INTO FUNCTIONAL SPINAL MOTOR NEURONS, AND

METHODS AND USES THEREOF

FIELD OF INVENTION

[001] The invention relates to methods for transdifferentiation of a somatic cell, e.g., a fibroblast to a cell having motor neuron characteristics. The present invention also relates to an isolated population comprising induced motor neurons, compositions and their use in the treatment of motor neuron diseases and disorders (MNDs).

CROSS REFERENCE TO RELATED APPLICATION

[002] This application claims benefit under 35 U.S.C. § 119(e) of the U.S. Provisional Application Serial No. 61/524,599 filed on August 17, 2011, the contents of which is incorporated herein in its entirety by reference.

GOVERNMENT SUPPORT

[003] This invention was made with made with Government Support under Contract Nos: NS069395, HD045732, and GM007592 awarded by the National Institutes of Health. The Government has certain rights in the invention.

SEQUENCE LISTING

[004] The instant application contains a Sequence Listing which has been submitted in ASCII format via EFS-Web and is hereby incorporated by reference in its entirety. Said ASCII copy was created on August 15, 2012, is named 071451PCT.txt and is 128,713 bytes in size.

BACKGROUND OF THE INVENTION

[005] The mammalian nervous system is composed of a multitude of distinct neuronal subtypes, each with its own phenotype and differential sensitivity to degenerative disease. Although specific neuronal types can be isolated from rodent embryos or engineered from stem cells for translational studies, transcription factor mediated reprogramming might provide a more direct route to their generation.

[006] The mammalian central nervous system (CNS) is assembled from a diverse collection of neurons, each with its own unique properties. These discrete characteristics underlie the proper integration and function of each neuron within the circuitry of the brain and spinal cord. However, their individual qualities also render particular neurons either resistant or sensitive to particular degenerative stimuli. Thus, for each neurodegenerative disease, a stereotyped set of neuronal subtypes is destroyed, causing the hallmark presentation of that condition. Therefore, if one is to comprehend the mechanisms that underlie the development, function and degeneration of the CNS, it is important to first deeply understand the properties of individual neuronal subtypes.

[007] Physiological and biochemical studies of individual neuronal types have been greatly facilitated by the ability to isolate distinct classes of neurons and interrogate them in vitro. Most studies have focused on neurons isolated from the developing rodent CNS. However, it is not routinely possible to isolate analogous populations of human neurons or to isolate and fully study differentiated central neurons. Pluripotent stem cells, such as embryonic stem cells (ESCs), may provide an inexhaustible reservoir of diverse neural subtypes, offering an attractive approach for in vitro studies (Wichterle et al., 2002). Although stem cells have shown great promise, to date, only a handful of neural subtypes have been produced in this way. Furthermore, in many cases the neuronal populations produced from stem cells have not been shown to possess refined subtype specific properties and may only superficially resemble their counterparts from the CNS (Peljto and Wichterle, 2011).

[008] Experiments using the reprogramming of one set of differentiated cells directly into another suggest an alternative approach for the generation of precisely defined neural subtypes. Using distinct sets of transcription factors, it is possible to reprogram fibroblasts into pluripotent stem cells (Takahashi and Yamanaka, 2006), blood progenitors (Szabo et al., 2010), cardiomyocytes (Ieda et al., 2010) as well as functional, post-mitotic neurons (Caiazzo et al.; Pfisterer et al., 2011; Vierbuchen et al., 2010). Thus, it may be possible to use factors which act on cells intrinsically, rather than relying on morphogens that act extrinsically to more precisely specify the exact properties of a wide array of neuronal types. Most reprogramming studies have so far only produced induced neurons (iNs) with an unknown

developmental ontogeny and a generic phenotype (Pang et al., 2011 ; Pfisterer et al., 2011 ; Vierbuchen et al., 2010). Recently, two studies have generated cells that resemble dopaminergic neurons based on the production of tyrosine hydroxylase (Caiazzo et al.; Pfisterer et al., 2011). However, it is unclear whether these cells are molecularly and functionally equivalent to embryo- or ESC-derived dopaminergic neurons. In particular, it has yet to be determined whether any type of neuron made by reprogramming can survive and properly integrate into the CNS. If neuronal reprogramming is to be successfully applied to the study of CNS function or degeneration, then it must be capable of producing specific neuronal types that possess the correct phenotypic properties both in vitro and in vivo.

[009] Motor neurons control the contraction of muscle fibers actuating movement. Damage to motor neurons caused by either injury or disease can result in paralysis or death; consequently, there is significant interest in understanding how motor neurons regenerate after nerve injury and why they are selective targets of degeneration in diseases such as spinal muscular atrophy (SMA) and amyotrophic lateral sclerosis (ALS). There is a need to produce functional motor neurons for the treatment of motor neuron degenerative diseases and disorders.

SUMMARY OF THE INVENTION

[0010] The present invention relates to compositions and a method for direct reprogramming (i.e. transdifferentiation, or cellular reprogramming) of a fibroblast cell to a cell having characteristics of a functional motor neuron. In particular, the present invention relates to a method for direct conversion of a fibroblast cell by increasing the protein expression of at least three motor neuron inducing (MN- inducing factors), selected from any of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl, in the somatic cell.

[0011] Accordingly, the present invention relates to methods, compositions and kits for producing a functional motor neuron (iMN) from a fibroblast. Other embodiments of the present invention relate to an isolated population of functional motor neurons (iMNs) produced by the methods as disclosed herein, and an isolated population of functional iMNs by increasing the protein expression of at least three motor neuron inducing (MN-inducing factors), selected from any of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in a fibroblast cell, and methods of their use.

[0012] Herein, the inventors have demonstrated that the forced expression of a group of select transcription factors is sufficient to convert mouse and human fibroblasts into induced motor neurons (iMNs). iMNs displayed a morphology, gene expression signature, electrophysiology, synaptic functionality, in vivo engraftment capacity and sensitivity to degenerative stimuli, similar to embryo- derived motor neurons. In particular, the inventors demonstrate that the converting fibroblasts do not transit through a proliferative neural progenitor state, and thus form bona fide motor neurons via a route distinct from embryonic development. The inventors have successfully demonstrated that fibroblasts can be converted directly into a specific differentiated and functional spinal motor neuron subtype, referred to herein as "iMN" or "induced motor neuron". Importantly, the inventors demonstrate that iMNs are a distinct neuronal subtype with different functional characteristics to other neuronal subtypes derived from fibroblasts, which are commonly referred to as iNs (induced neurons).

[0013] In some embodiments, iMNs exhibit characteristic of normal motor neurons (e.g., motor neurons differentiated from embryonic stem cells (ESCs)) and can express at least two motor neuron specific genes selected from the group consisting of: 2-tubulins (e.g, Tubb2a and Tubb2b), Map2, synapsins (e.g., Synl and Syn2), synaptophysin, synaptotagmins (e.g., Sytl, Syt4, Sytl3, Syt 16), NeuroD, Isll, cholineacetyltransferase (ChAT), e.g., vescular ChAT. In some embodiments, the iMNs have decreased level of expression of fibroblast genes from which they are derived, e.g., have decreased expression of any of the following genes selected from the group of: Snaill, thyl and Fspl.

[0014] In some embodiments, the iMNs generated by the methods as disclosed herein exhibit typical motor neuron morphology, e.g., comprising a cell body with axonal projections which form functional synaptic junctions with muscle cells.

[0015] In some embodiments, iMNs generated by the methods as disclosed herein have an average resting potential of lower than about -50mV, e.g., between -48 to -51 mV, or about -49.5 mV, which is similar to motor neurons differentiated from embryonic stem cells. In some embodiments, the iMN can have a resting potential of about -50mV to about -65mV and any integer between, e.g., about -50mV, or about -50 to -55mV or about -55mV to about -60mV or about -60mV to about -65mV. In some embodiments, the iMNs generated by the methods as disclosed herein exhibit the ability to fire action potentials, are responsive to inhibitor neurotransmitters, e.g., produce an outward current in response to glycine and GABA, and are responsive to excitatory neurotransmitters, e.g., produce an inward current in response to glutamate or kainate.

[0016] In some embodiments, iMNs and compositions comprising iMNs are produced by the methods comprising contacting a somatic cell, or a population of somatic cells with an agent, such as a nucleic acid agent, or nucleic acid analogue, peptide, polypeptide aptamer, antibody, antibody fragment, ribosomes, small molecule and the like, which increases the protein expression of at least three transcription factors selected from any combination of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in a somatic cell, e.g., a fibroblast. In some embodiments, iMNs can be produced by introducing a nucleic acid sequence or nucleic acid analogue encoding at least three MN-inducing factors Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl or functional fragments thereof into a somatic cell, e.g., a fibroblast. In some embodiments, a nucleic acid sequence which encodes at least three MN-inducing factors Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl or functional fragments thereof is expressed transiently for a transient increase the protein expression of the polypeptides MN-inducing factors Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in the somatic cell, e.g., fibroblast.

[0017] One aspect of the present invention provides a method for transdifferentiation of a somatic cell, e.g., a fibroblast, the method comprising increasing the protein expression of at least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in the somatic cell, e.g, fibroblast cell, wherein the somatic cell is converted to an induced motor neuron (iMN) and exhibits at least two characteristics of a motor neuron, for example, but not limited to, motor neuron morphology, firing action potentials, responsive to inhibitory neurotransmitters, glycine, GABA or kainate, responsive to excitatory neurotransmitters, e.g., glutamate, and express motor-neuron specific markers, selected from, but not limited to: 2-tubilins (e.g, Tubb2a and Tubb2b), Map2, synapsins (e.g., Synl and Syn2), synaptophysin, synaptotagmins (e.g., Sytl, Syt4, Sytl3, Syt 16), NeuroD, Isll, cholineacetyltransf erase (ChAT), e.g., vescular ChAT. In some embodiments, the protein expression of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl are increased in a somatic cell, e.g., fibroblast.

[0018] In some embodiments, in increase in the protein expression of least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl can be achieved by contacting a somatic cell, e.g., a fibroblast with an agent which increases the expression of the MN- inducing factor, where an agent can be selected from the group consisting of: a nucleotide sequence, a nucleic acid analogue (e.g., Locked nucleic acid (LNA), modified RNA (modRNA)), a protein, an aptamer and small molecule, ribosome, RNAi agent and peptide-nucleic acid (PNA) and analogues or variants thereof. In some embodiments, protein expression is increased by introducing at least three nucleic acid sequences encoding at least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl, or encoding a functional fragment thereof, in the somatic cell, e.g., fibroblast. [0019] In some embodiments, protein expression of Lhx3 is increased by introducing a nucleic acid sequence encoding a Lhx3 polypeptide comprising SEQ ID NO: 1 or SEQ ID NO: 2 or a functional fragment of SEQ ID NO: 1 or SEQ ID NO: 2 into the somatic cell, e.g., fibroblast.

[0020] In some embodiments, protein expression of Ascll is increased by introducing a nucleic acid sequence encoding a Ascll polypeptide comprising SEQ ID NO: 3 or SEQ ID NO: 4 or a functional fragment of SEQ ID NO: 3 or SEQ ID NO: 4 into the somatic cell, e.g., fibroblast.

[0021] In some embodiments, protein expression of Brn2 is increased by introducing a nucleic acid sequence encoding a Brn2 polypeptide comprising SEQ ID NO: 5 or SEQ ID NO: 6 or a functional fragment of SEQ ID NO: 5 or SEQ ID NO: 6 into the somatic cell, e.g., fibroblast.

[0022] In some embodiments, protein expression of Mytll is increased by introducing a nucleic acid sequence encoding a Mytll polypeptide comprising SEQ ID NO: 7 or SEQ ID NO: 8 or a functional fragment of SEQ ID NO: 7 or SEQ ID NO: 8 into the somatic cell, e.g., fibroblast.

[0023] In some embodiments, protein expression of Isll is increased by introducing a nucleic acid sequence encoding a Isll polypeptide comprising SEQ ID NO: 9 or SEQ ID NO: 10 or a functional fragment of SEQ ID NO: 9 or SEQ ID NO: 10 into the somatic cell, e.g., fibroblast.

[0024] In some embodiments, protein expression of Hb9 is increased by introducing a nucleic acid sequence encoding a Hb9 polypeptide comprising SEQ ID NO: 11 or SEQ ID NO: 12 or a functional fragment of SEQ ID NO: 11 or SEQ ID NO: 12 into the somatic cell, e.g., fibroblast.

[0025] In some embodiments, protein expression of Ngn2 is increased by introducing a nucleic acid sequence encoding a Ngn2 polypeptide comprising SEQ ID NO: 13 or SEQ ID NO: 14 or a functional fragment of SEQ ID NO: 13 or SEQ ID NO: 14 into the somatic cell, e.g., fibroblast.

[0026] In some embodiments, protein expression of NeuroDl is increased by introducing a nucleic acid sequence encoding a NeuroDl polypeptide comprising SEQ ID NO: 15 or SEQ ID NO: 16 or a functional fragment of SEQ ID NO: 15 or SEQ ID NO: 16 into the somatic cell, e.g., fibroblast.

[0027] In some embodiments, a nucleic acid sequence is in a vector, such as a viral vector or a non- viral vector. In some embodiments, the vector is a viral vector comprising a genome that does not integrate into the host cell genome.

[0028] In some embodiments, somatic cell, e.g., fibroblast is in vitro. In some embodiments, somatic cell, e.g., fibroblast is ex vivo.

[0029] In some embodiments, a subject is a human subject. In some embodiments, the subject has, or is at risk of developing a motor neuron disease or disorder, e.g., ALS or spinal muscular atrophy (SMA). In some embodiments, a somatic cell, e.g., fibroblast is a mammalian cell, such as a human cell.

[0030] In some embodiments, the vector comprises a nucleic acid sequence encoding a Lhx3 polypeptide or a functional fragment thereof, and/or comprises a nucleic acid sequence encoding a Ascll polypeptide or a functional fragment thereof and/or comprises a nucleic acid sequence encoding a Brn2 polypeptide or a functional fragment thereof, and/or comprises a nucleic acid sequence encoding a Mytll polypeptide or a functional fragment thereof, and/or comprises a nucleic acid sequence encoding a Isll polypeptide or a functional fragment thereof, and/or comprises a nucleic acid sequence encoding a Hb9 polypeptide or a functional fragment thereof, and/or comprises a nucleic acid sequence encoding a Ngn2 polypeptide or a functional fragment thereof, and/or comprises a nucleic acid sequence encoding a NeuroDl polypeptide or a functional fragment thereof.

[0031] Another aspect of the present invention relates to a method for the treatment of a subject with a motor neuron disease or disorder, the method comprising administering a composition comprising an isolated population of iMNs according to the methods as disclosed herein.

[0032] Another aspect of the present invention relates to the use of the isolated population of iMNs produced by the methods as disclosed herein for administering to a subject in need thereof.

[0033] In some embodiments, iMNs can be produced from somatic cells, e.g., fibroblasts obtained from the same subject as the composition is administered to (e.g., autologous iMNs). In alternative embodiments, the iMNs are produced from a donor subject (e.g., allogenic iMNs). In some

embodiments, the subject has, or has an increased risk of developing a motor neuron disease or disorder, e.g., ALS, SMA, or PLS or other motor neuron diseases as disclosed herein.

[0034] Another aspect of the present invention relates to kits for producing iMNs as disclosed herein. In some embodiments, a kit comprises (i) a nucleic acid sequence encoding a Lhx3 polypeptide or a functional fragment thereof; and/or (ii) a nucleic acid sequence encoding a Ascll polypeptide or a functional fragment thereof; and/or (iii) a nucleic acid sequence encoding a Brn2 polypeptide or a functional fragment thereof, and/or (iv) a nucleic acid sequence encoding a My til polypeptide or a functional fragment thereof, and/or (v) a nucleic acid sequence encoding a Ml polypeptide or a functional fragment thereof, and/or (vi) a nucleic acid sequence encoding a Hb9 polypeptide or a functional fragment thereof, and/or (vii) a nucleic acid sequence encoding a Ngn2 polypeptide or a functional fragment thereof, and/or (viii) a nucleic acid sequence encoding a NeuroDl polypeptide or a functional fragment thereof. In some embodiments, the kit further comprises instructions for direct conversion of a somatic cell, e.g., fibroblast to an iMN cell with at least two characteristics of a motor neuron which is differentiated from a embryonic stem cell.

[0035] Another aspect of the present invention relates to methods of identifying agents that alone or in combination with other agents directly convert somatic cell, e.g., fibroblast to a iMN. In some embodiments, the method includes contacting one or more somatic cell, e.g., fibroblast with one or more test agents (simultaneously or at separate times) and determining the presence of a iMN comprising at least two characteristics of a motor neuron which is differentiated from an embryonic stem cell. The test agents may include, but are not limited to, small molecules, nucleic acids, peptides, polypeptides, immunoglobulins, and oligosaccharides. In some embodiments, the method includes determining the level of expression of one or more of the MN-inducing factors selected from the group consisting of: Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl. Expression levels can be determined by any means known by one of ordinary skill in the art, for example, by RT-PCR or immunological methods. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] This patent or application file contains at least one drawing executed in color.. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

[0037] Figures 1A-1G show the generation of H&9::GFP+ Induced Motor Neurons by 7 Factors. Figure 1A shows a schematic of the experimental outline. 11 candidate transcription factors include eight developmental genes in addition to the three iN factors. Figure IB shows immunostaining of H&9::GFP+ neurons express Tuj l. Scale bars represent 40 m. Figure 1C shows iMNs generated with 10 factors (without Isll) express endogenous Islet. Scale bars represent 40 μπι. Figure ID shows Isll is dispensable for generating iMNs. Scale bar represents 200 μπι. Figure IE shows the reprogramming efficiency is greater with Hb9 or Isll on top of 4 factors (Lhx3, Ascll, Brn2 and Mytll) at day 21 post- transduction. Error bars indicate +s.d. *P <0.05 (Student's i-test, twotailed). Figure IF shows the addition of Ngn2 to the 6-f actor pool (Hb9, Isll, Lhx3, Ascll, Brn2 and Mytll) greatly enhances reprogramming efficiency as seen 10 days after transduction. Error bars indicate +s.d.***P<0.001 ; **P <0.01 (Student's i-test, two-tailed). Figure 1G shows the 7 iMN factors convert adult tail tip fibroblasts into motor neurons. Scale bar representslOO μπι.

[0038] Figure 2A-2E shows iMNs Possess Gene Expression Signatures of Motor Neurons. Figure 2A shows the global transcriptional analysis of FACS-purified H&9::GFP+ motor neurons. iMNs cluster with control motor neurons and away from MEFs. Figures 2B-2D show pairwise gene expression comparisons show that iMNs are highly similar to embryo derived motor neurons and dissimilar from the starting MEFs; labeled genes denotes genes that are expressed in motor neurons, genes labeled with an asterix (*) denotes genes expressed in fibroblasts, and the lines indicate the diagonal and 2-fold changes between the sample pairs. Figure 2E is results of qRT-PCR data showing expression of endogenous transcripts of the 7 iMN factors relative to their levels in ES-MNs. Error bars indicate + s.d.

[0039] Figures 3A-3D show iMNs Express Neuronal and Motor Neuron Proteins. Figure 3A shows iMNs express the pan-neuronal marker Map2. Scale bars represent 100 μπι. Figure 3B shows iMNs express synapsin. Scale bars represent 20 μπι. Figure 3C shows iMNs express vesicular

cholineacetyltransferase (vChAT). Scale bars represent 40 μπι. Figure 3D shows iMNs express the motor neuron-selective transcription factor Hb9. Scale bars represent 80 μπι.

[0040] Figures 4A-4J show Electrophysiological Activity and In Vitro Functionality of iMNs. Figure 4A shows iMNs express functional sodium channels. Figure 4B shows iMNs express functional sodium and potassium channels. Figure 4C shows iMN sodium channel activity is appropriately blocked by tetrodotoxin (TTX). Figure 4D shows iMNs fire a single action potential upon depolarization. Figure 4E shows iMNs fire multiple action potentials upon depolarization. Figure 4F shows 100 μΜ GABA induces inward currents in iMNs. Figure 4G shows 100 μΜ glycine induces inward currents in iMNs. Figure 4H shows 100 μΜ kainate induces inward currents in iMNs. Figure 41 shows iMN-induced contractions of C2C12 myotubes are blocked by 50 μΜ curare. The arrow indicates the timing of curare addition. Figure 4J shows iMNs cultured with chick myotubes form NMJs with characteristic oc- bungarotoxin (oc-BTX, red) staining. The dotted line outlines the boundaries of a myotube. Scale bar represents 5 μπι.

[0041] Figures 5A-5F show In Vivo Functionality and In Vitro Utility of iMNs. Figure 5A is a schematic diagram showing the injection of iMNs into the neural tube of the stage 17 chick embryo. Figure 5B shows transverse sections of iMN-injected chick neural tube 5 day after transplantation. Arrows in both panels indicate the same axon of an iMN exiting the spinal cord through the ventral root. D: dorsal, V: ventral, VR: ventral root. Figure 5C shows FACS-purified Hb9::GFP+ iMNs co-cultured with wild-type or the mutant SOD1G93A overexpressing glia for 10 days. Scale bars represent 5 μπι. Figure 5D shows the quantification of Fig 5C. Error bars indicate +s.d. **P <0.01 (Student's i-test, two- tailed). Figure 5E shows SOD1G93A iMNs exhibit reduced survival in culture with wild-type glia. Error bars indicate +s.d. **P <0.01 (Student's i-test, two-tailed). Figure 5F shows the changes in iMN number after 9 days of culture in the presence or absence of neurotrophic factors (GDNF, BDNF and CNTF). Error bars indicate +s.d. **P <0.01 (Student's ί-test, twotailed).

[0042] Figures 6A-6D show transdifferention Does Not Occur Through a Nestin+ Neural Progenitor State. Figure 6A shows the percentage of iMNs that have incorporated BrdU. Figure 6B shows an outline of the lineage tracing experiment using Nestin: :CreER; LOX-STOP-LOX-H2BmCherry;

Hb9::GFP iPSCs or MEFs. To detect Nestin+ intermediates, cultures were treated with 1-2 μΜ 4-ΟΗΤ during directed diffentiation of iPSCs (positive control) or during transdifferentiation of fibroblasts by the 7 factors. Figure 6C shows FACS-purified, mCherry+ Hb9::GFP+ motor neurons derived from the triple transgenic iPSCs in the presence of 1 μΜ 4-ΟΗΤ. Expression of mCherry was observed in 3% of H&9::GFP+ cells (n > 10,000) and indicates the activation of Nestin: :CreER during directed differentiation. Scale bars represent 40 μπι. Figure 6D shows mCherry- H&9::GFP+ iMNs generated from the triple transgenic MEFs by transdifferentiation in the presence of 2 μΜ 4-ΟΗΤ. mCherry+ iMNs were never observed (n > 5,000), suggesting a Nestin+ state is not accessed during

reprogramming. Scale bars represent 40 μπι.

[0043] Figures 7A-7G shows Human iMNs Generated by 8 Transcription Factors. Figure 7A shows an Hb9::GFP+ neuron generated from a HEF culture by 8 transcription factors. Scale bars represent 80 μπι. Figure 7B shows quantification of human iMN reprogramming efficiency at day 30 post-transduction. Figure 7C shows human iMNs express vesicular choline acetyltransf erase (vChAT). Scale bars represent 80 μπι. Figure 7D shows human iMNs express functional sodium and potassium channels. Figure 7E shows human iMNs fire action potentials upon depolarization. Figure 7F shows 100 μΜ kainate induces inward currents in human iMNs. Figure 7G shows 100 μΜ GABA induces inward currents in human iMNs. [0044] Figures 8A-8E are related to Figure 1 and show the induction of H&9::GFP+ Neurons from Fibroblast Cultures. Figure 8A shows H&9::GFP+ cells are generated from MEFs by transduction with 8 or 11 factors by day 35 post-transduction, but more efficiently by 11 factors. Scale bars represent 50 μπι. Figure 8B shows the eficiency of reprogramming 35 days post-transduction when each factor is omitted from the 11 -factor pool individually. Error bars indicate +s.d. Figure 8C shows Lhx3 and Ascll are not sufficient to convert fibroblasts into motor neurons. Error bars indicate +s.d. *** p<0.001 (Student's i-test, two-tailed). Figure 8D shows that adding each of the neural progenitor factors to 7 factors (Ngn2 + 6 factors) inhibits iMN formation as seen 10 days after transduction. Error bars indicate +s.d. ***P<0.001 ; **P <0.01 (Student's ί-test, two-tailed). Figure 8E shows N3 medium promotes iMN accumulation. Efficiency of fibroblast-to-iMN reprogramming in two different media conditions. Error bars indicate +s.d.

[0045] Figure 9Α-9Η, is related to Figures 2 and 3. iMNs Possess Molecular Signatures of Motor Neurons. Figure 9A shows iMN morphology is similar to that of embryonic and ESC-derived motor neurons. Scale bars represent 100 μπι. Figures 9B-9F show microarray analysis reveals that iMNs have a motor neuron-like gene expression signature. Figure 9B shows iMNs express the pan-neuronal genes Map2 and b2-tubulin. Figure 9C shows iMNs express genes required for synapse formation. Figure 9D shows iMNs endogenously express transcription factors expressed in motor neurons. Figure 9E shows iMNs endogenously express choline ace tyltransf erase. Figure 9F shows fibroblast-specific genes are downregulated in iMNs. mRNA expression levels are shown relative to an embryonic motor neuron control (9B-9E) or relative to a MEF control (9F). All motor neuron samples were FACS-purified by Hb9::GFP expression prior to mRNA extraction. Figure 9G shows immunostaining of 7 factor iMNs for tyrosine hydroxylase (ΤΗ). A rare ΤΗ+ iMN with a low level of Hb9::GFP reporter expression is shown on the right. Scale bars represent 200 μπι. Figure 9Η shows iMNs have not silenced viral transgenes. qRT-PCR using primers for the viral transcripts of 7 iMN factors. Expression levels shown relative to ESC-derived motor neurons.

[0046] Figures 10A-10L is related to Figure 4 and shows electrophysiological Activity and In Vitro Functionality of iMNs. Figure 10A-10D show tail tip fibroblast-derived iMNs exhibit electrophysiology characteristic of motor neurons. Figure 10A shows sodium and potassium currents. Figure 10B shows single and multiple action potentials. Figure IOC shows inward current in response to 100 μΜ GAB A. Figure 10D shows inward current in response to 100 μΜ kainate. Figures 10E-10G show iMNs express genes required for ion channel function and neurotransmitter response. Figure 10 E shows sodium channel mRNA expression levels relative to an embryo-derived motor neuron control genes. Figure 10F shows potassium channel mRNA expression levels relative to an embryo-derived motor neuron control genes. Figure 10G shows glutamate receptor mRNA expression levels relative to an embryo-derived motor neuron control genes. All motor neuron samples were FACS-purified by Hb9::GFP expression prior to mRNA extraction. Figure 10Η shows iMNs co-cultured with a monolayer of C2C12 myotubes. Scale bar represents 200μπι. Figures 101- 10L show iMNs induce acetylcholine receptor clustering and form anatomical endplates on cultured myotubes. Figure 101 shows fluorescence image of GFP+ iMNs after 7 weeks of coculture with chick myotubes. Figure 10J shows rhodamine -conjugated a-BTX staining showed Ach clustering occurred on the chick myotubes. Figure 10K shows merged image of Fig 101 and Fig 10J) showed Ach receptors clustering preferentially occurred near the GFP+ axons (open arrowhead) and at the end of the neurites at putative endplates regions (arrows). ACh clusters were less pronounced on myotubes not associated with axons (arrowhead). Figure 10L shows confocal image depicting a GFP+ axon co-localized with acetylcholine receptors at a putative endplate in a 3- week co-culture. Imaging in both the x-z and y-z orthogonal planes confirms the close proximity of the receptors to the axon terminal. Scale bars represent 50 μπι (Fig 10K) and 5 μπι (Fig 10L).

[0047] Figure 11 is related to Figure 5, and shows mouse ESC-Derived Motor Neurons Integrate into the Developing Chick CNS. ESC-derived motor neurons (asterisks) engrafted into the ventral horn and extended axons out of the spinal cord through the ventral root (arrow) 5 days after transplantation into an E2.5 chick embryo neural tube. Scale bar represents 100 μπι.

DETAILED DESCRIPTION OF THE INVENTION

[0048] The present invention provides compositions and methods for producing functional motor neurons from fibroblast cells. In some embodiments, the present invention provides compositions and methods for direct conversion of fibroblast cells to functional motor neurons (iMNs), without the somatic cell, e.g., fibroblast becoming an induced pluripotent stem cell (iPS) intermediate prior to being transdifferentated into a functional motor neuron.

[0049] The present invention relates to a population of induced motor neurons (iMNs) from a somatic cell, e.g., fibroblast, and methods and compositions for the direct reprogramming cells, such as a somatic cell, e.g., fibroblast to an iMN. In particular, the present invention relates to a method for transdifferentiation of a somatic cell, e.g., fibroblast by increasing the protein expression of at least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in the somatic cell, e.g., fibroblast. In some embodiments, the method comprises increasing the expression of least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl. In some embodiments, the method comprises increasing the protein expression of a functional fragment of of least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in a somatic cell, e.g., fibroblast. In some embodiments, the method further comprises increasing the protein expression of additional MN-inducing factors in addition to at least 8 factors disclosed herein.

[0050] Accordingly, the present invention relates to methods, compositions and kits for producing an induced motor neuron (iMN) from a somatic cell, e.g., fibroblast. Other embodiments of the present invention relate to an isolated population of induced motor neurons (iMNs) by increasing the protein expression of least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in the somatic cell, e.g., fibroblast.

[0051] In some embodiments, an isolated population of iMNs produced by the methods and compositions as disclosed herein is a mammalian iMN, for example, a human iMN.

[0052] In some embodiments, an isolated population of iMNs and compositions are produced by a method comprising contacting a cell or a population of a somatic cell, e.g., fibroblast with an agent, such as a nucleic acid agent, peptide, polypeptide aptamer, antibody, antibody fragment, ribosomes, small molecules, RNAi agents, ribosomes and the like, which increase the protein expression of least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in the somatic cell, e.g., fibroblast. In some embodiments, the method to produce an isolated population of iMNs comprises introducing a nucleic acid sequence encoding of least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl or functional fragments thereof into the somatic cell, e.g., fibroblast. In some embodiments, the nucleic acid sequence encoding of least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl ,or functional fragments thereof is expressed transiently for a transient increase the protein expression of the polypeptides of least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl in the somatic cell, e.g., fibroblast.

[0053] In some embodiments, the method comprises increasing the protein expression of at least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl of SEQ ID NOs 1-8, or functional fragments of proteins of SEQ ID NO: 1-8 respectively for human polypeptide sequences. In some embodiments, the method comprises increasing the protein expression of at least three MN-inducing factors selected from any of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl of SEQ ID NOs 1-16, or functional fragments of proteins of SEQ ID NO: 1-16 respectively for human and mouse polypeptides.

DEFINITIONS:

[0054] For convenience, certain terms employed herein, in the specification, examples and appended claims are collected here. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs.

[0055] The term "transdifferentiation" is used interchangeably herein with the phrase "direct conversion" or "direct reprogramming" and refers to the conversion of one differentiated somatic cell type into a different differentiated somatic cell type without undergoing complete reprogramming to an induced pluripotent stem cell (iPSC) intermediate .

[0056] The term "reprogramming" as used herein refers to the process that alters or reverses the differentiation state of a somatic cell. The cell can either be partially or terminally differentiated prior to the reprogramming. Reprogramming encompasses complete reversion of the differentiation state of a somatic cell to a pluripotent cell. Such complete reversal of differentiation produces an induced pluripotent (iPS) cell. A partial reversal of differentiation produces a partially induced pluripotent (PiPS) cell. Reprogramming also encompasses partial reversion of the differentiation state, for example to a multipotent state or to a somatic cell that is neither pluripotent or multipotent, but is a cell that has lost one or more specific characteristics of the differentiated cell from which it arises, e.g. direct

reprogramming of a differentiated cell to a different somatic cell type. Reprogramming generally involves alteration, e.g., reversal, of at least some of the heritable patterns of nucleic acid modification (e.g., methylation), chromatin condensation, epigenetic changes, genomic imprinting, etc., that occur during cellular differentiation as a zygote develops into an adult.

[0057] The term "pluripotent" as used herein refers to a cell with the capacity, under different conditions, to differentiate to more than one differentiated cell type, and preferably to differentiate to cell types characteristic of all three germ cell layers. Pluripotent cells are characterized primarily by their ability to differentiate to more than one cell type, preferably to all three germ layers, using, for example, a nude mouse teratoma formation assay. Pluripotency is also evidenced by the expression of embryonic stem (ES) cell markers, although the preferred test for pluripotency is the demonstration of the capacity to differentiate into cells of each of the three germ layers.

[0058] The term "differentiated cell" is meant any primary cell that is not, in its native form, pluripotent as that term is defined herein. It should be noted that placing many primary cells in culture can lead to some loss of fully differentiated characteristics. However, simply culturing such cells does not, on its own, render them pluripotent. The transition to pluripotency requires a reprogramming stimulus beyond the stimuli that lead to partial loss of differentiated character in culture. Reprogrammed pluripotent cells also have the characteristic of the capacity of extended passaging without loss of growth potential, relative to primary cell parents, which generally have capacity for only a limited number of divisions in culture. Stated another way, the term "differentiated cell" refers to a cell of a more specialized cell type derived from a cell of a less specialized cell type (e.g., a stem cell such as an induced pluripotent stem cell) in a cellular differentiation process.

[0059] As used herein, the term "somatic cell" refers to are any cells forming the body of an organism, as opposed to germline cells. In mammals, germline cells (also known as "gametes") are the

spermatozoa and ova which fuse during fertilization to produce a cell called a zygote, from which the entire mammalian embryo develops. Every other cell type in the mammalian body— apart from the sperm and ova, the cells from which they are made (gametocytes) and undifferentiated stem cells— is a somatic cell: internal organs, skin, bones, blood, and connective tissue are all made up of somatic cells. In some embodiments the somatic cell is a "non-embryonic somatic cell", by which is meant a somatic cell that is not present in or obtained from an embryo and does not result from proliferation of such a cell in vitro. In some embodiments the somatic cell is an "adult somatic cell", by which is meant a cell that is present in or obtained from an organism other than an embryo or a fetus or results from proliferation of such a cell in vitro. Unless otherwise indicated the methods for direct conversion of a somatic cell, e.g., fibroblast to a iMN can be performed both in vivo and in vitro (where in vivo is practiced when somatic a somatic cell, e.g., fibroblast are present within a subject, and where in vitro is practiced using isolated somatic a somatic cell, e.g., fibroblast maintained in culture).

[0060] As used herein, the term "adult cell" refers to a cell found throughout the body after embryonic development.

[0061] As used herein, the terms "iPS cell" and "induced pluripotent stem cell" are used

interchangeably and refers to a pluripotent stem cell artificially derived (e.g., induced or by complete reversal) from a non-pluripotent cell, typically an adult somatic cell, for example, by inducing a forced expression of one or more genes.

[0062] The term "motor neuron" also referred to as a "motoneuron" refers to a neuron that sends electrical output signals to a muscle, gland, or other effector tissue.

[0063] The term "induced motor neuron" or "iMN" as used herein refers to a functional motor neuron produced by direct conversion from a somatic cell, e.g., a fibroblast.

[0064] The term "functional" as used in relation to a functional motor neuron refers to a motor neuron which can fire action potentials and can signal a muscle to contract. A functional motor neuron expresses ChAT, an enzyme necessary for synthesizing the motor neuron transmitter acetylcholine, and expresses VAChAT, which is necessary for the storage and uptake of the transmitter acetylcholine, and expresses synapsin for formation of synapses, and can transmit action potentials and synapse with muscle cells to result in muscle contraction.

[0065] As used herein, the term "endogenous motor neuron" refers to a motor neuron in vivo or a motor neuron produced by differentiation of an embryonic stem cell into a motor neuron, and exhibiting an adult motor neuron phenotype. The phenotype of a motor neuron is well known by persons of ordinary skill in the art, and include, for example, formation of synaptic junctions with muscle cells, expression of ChAT, immunostaining with aBTX, responsive to inhibitory and excitatory neurotransmitters, as well as distinct morphological characteristics such long axonal projections and synaptic connections with muscle cells.

[0066] The term "progenitor cell" is used herein to refer to cells that have a cellular phenotype that is more primitive (i.e., is at an earlier step along a developmental pathway or progression than is a fully differentiated cell) relative to a cell which it can give rise to by differentiation. Often, progenitor cells also have significant or very high proliferative potential. Progenitor cells can give rise to multiple distinct differentiated cell types or to a single differentiated cell type, depending on the developmental pathway and on the environment in which the cells develop and differentiate.

[0067] The term "stem cell" as used herein, refers to an undifferentiated cell which is capable of proliferation and giving rise to more progenitor cells having the ability to generate a large number of mother cells that can in turn give rise to differentiated, or differentiable daughter cells. The daughter cells themselves can be induced to proliferate and produce progeny that subsequently differentiate into one or more mature cell types, while also retaining one or more cells with parental developmental potential. The term "stem cell" refers to a subset of progenitors that have the capacity or potential, under particular circumstances, to differentiate to a more specialized or differentiated phenotype, and which retains the capacity, under certain circumstances, to proliferate without substantially differentiating. In one embodiment, the term stem cell refers generally to a naturally occurring mother cell whose descendants (progeny) specialize, often in different directions, by differentiation, e.g., by acquiring completely individual characters, as occurs in progressive diversification of embryonic cells and tissues. Cellular differentiation is a complex process typically occurring through many cell divisions. A differentiated cell may derive from a multipotent cell which itself is derived from a multipotent cell, and so on. While each of these multipotent cells may be considered stem cells, the range of cell types each can give rise to may vary considerably. Some differentiated cells also have the capacity to give rise to cells of greater developmental potential. Such capacity may be natural or may be induced artificially upon treatment with various factors. In many biological instances, stem cells are also "multipotent" because they can produce progeny of more than one distinct cell type, but this is not required for "sternness." Self-renewal is the other classical part of the stem cell definition, and it is essential as used in this document. In theory, self-renewal can occur by either of two major mechanisms. Stem cells may divide asymmetrically, with one daughter retaining the stem state and the other daughter expressing some distinct other specific function and phenotype. Alternatively, some of the stem cells in a population can divide symmetrically into two stems, thus maintaining some stem cells in the population as a whole, while other cells in the population give rise to differentiated progeny only. Formally, it is possible that cells that begin as stem cells might proceed toward a differentiated phenotype, but then "reverse" and re- express the stem cell phenotype, a term often referred to as "dedifferentiation" or "reprogramming" or "retrodifferentiation" by persons of ordinary skill in the art.

[0068] In the context of cell ontogeny, the adjective "differentiated", or "differentiating" is a relative term meaning a "differentiated cell" is a cell that has progressed further down the developmental pathway than the cell it is being compared with. Thus, stem cells can differentiate to lineage -restricted precursor cells (such as a mesodermal stem cell), which in turn can differentiate into other types of precursor cells further down the pathway (such as an cardiomyocyte precursor), and then to an end-stage differentiated cell, which plays a characteristic role in a certain tissue type, and may or may not retain the capacity to proliferate further.

[0069] The term "embryonic stem cell" is used to refer to the pluripotent stem cells of the inner cell mass of the embryonic blastocyst (see US Patent Nos. 5843780, 6200806). Such cells can similarly be obtained from the inner cell mass of blastocysts derived from somatic cell nuclear transfer (see, for example, US Patent Nos. 5945577, 5994619, 6235970). The distinguishing characteristics of an embryonic stem cell define an embryonic stem cell phenotype. Accordingly, a cell has the phenotype of an embryonic stem cell if it possesses one or more of the unique characteristics of an embryonic stem cell such that that cell can be distinguished from other cells. Exemplary distinguishing embryonic stem cell characteristics include, without limitation, gene expression profile, proliferative capacity, differentiation capacity, karyotype, responsiveness to particular culture conditions, and the like.

[0070] The term "adult stem cell" or "ASC" is used to refer to any multipotent stem cell derived from non-embryonic tissue, including fetal, juvenile, and adult tissue. Stem cells have been isolated from a wide variety of adult tissues including blood, bone marrow, brain, olfactory epithelium, skin, pancreas, skeletal muscle, and cardiac muscle. Each of these stem cells can be characterized based on gene expression, factor responsiveness, and morphology in culture. Exemplary adult stem cells include neural stem cells, neural crest stem cells, mesenchymal stem cells, hematopoietic stem cells, and pancreatic stem cells. As indicated above, stem cells have been found resident in virtually every tissue.

Accordingly, the present invention appreciates that stem cell populations can be isolated from virtually any animal tissue.

[0071] The term a "MN-inducing factor", as used herein, refers to a gene whose expression, contributes to the direct conversion of a somatic cell, e.g., fibroblast, to a MN which exhibits at least two characteristics of an endogenous motor neuron. A MN-inducing factor be, for example, genes encoding transcription factors Lhx3 (SEQ ID NO: 1-2 encoded by SEQ ID NO: 17-18), Ascll (SEQ ID NO: 3-4 encoded by SEQ ID NO: 19-20), Brn2 (SEQ ID NO: 5-6 encoded by SEQ ID NO: 21-22), Mytll (SEQ ID NO: 7-8 encoded by SEQ ID NO: 23-24), Ml (SEQ ID NO: 9-10 encoded by SEQ ID NO: 25-26), Hb9 (SEQ ID NO: 11-12 encoded by SEQ ID NO: 27-28), Ngn2 (SEQ ID NO: 13-14 encoded by SEQ ID NO: 29-30) or NeuroDl (SEQ ID NO: 15-16 encoded by SEQ ID NO: 31-32).

[0072] The term "MN-inducing agent" refers to any agent which increases the protein expression of a MN-inducing factor, as that term is described herein. Preferably, a MN-inducing agent agent increases the expression of a MN-inducing factor selected from Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl.

[0073] The term "agent" as used herein means any compound or substance such as, but not limited to, a small molecule, nucleic acid, polypeptide, peptide, drug, ion, etc. An "agent" can be any chemical, entity or moiety, including without limitation synthetic and naturally-occurring proteinaceous and non- proteinaceous entities. In some embodiments, an agent is nucleic acid, nucleic acid analogues, proteins, antibodies, peptides, aptamers, oligomer of nucleic acids, amino acids, or carbohydrates including without limitation proteins, oligonucleotides, ribozymes, DNAzymes, glycoproteins, siRNAs, lipoproteins, aptamers, and modifications and combinations thereof etc. In certain embodiments, agents are small molecule having a chemical moiety. For example, chemical moieties included unsubstituted or substituted alkyl, aromatic, or heterocyclyl moieties including macrolides, leptomycins and related natural products or analogues thereof. Compounds can be known to have a desired activity and/or property, or can be selected from a library of diverse compounds.

[0074] The term "cell culture medium" (also referred to herein as a "culture medium" or "medium") as referred to herein is a medium for culturing cells containing nutrients that maintain cell viability and support proliferation. The cell culture medium may contain any of the following in an appropriate combination: salt(s), buffer(s), amino acids, glucose or other sugar(s), antibiotics, serum or serum replacement, and other components such as peptide growth factors, etc. Cell culture media ordinarily used for particular cell types are known to those skilled in the art.

[0075] The term "cell line" refers to a population of largely or substantially identical cells that has typically been derived from a single ancestor cell or from a defined and/or substantially identical population of ancestor cells. The cell line may have been or may be capable of being maintained in culture for an extended period (e.g., months, years, for an unlimited period of time). It may have undergone a spontaneous or induced process of transformation conferring an unlimited culture lifespan on the cells. Cell lines include all those cell lines recognized in the art as such. It will be appreciated that cells acquire mutations and possibly epigenetic changes over time such that at least some properties of individual cells of a cell line may differ with respect to each other.

[0076] The term "exogenous" refers to a substance present in a cell or organism other than its native source. For example, the terms "exogenous nucleic acid" or "exogenous protein" refer to a nucleic acid or protein that has been introduced by a process involving the hand of man into a biological system such as a cell or organism in which it is not normally found or in which it is found in lower amounts. A substance will be considered exogenous if it is introduced into a cell or an ancestor of the cell that inherits the substance. In contrast, the term "endogenous" refers to a substance that is native to the biological system.

[0077] The term "expression" refers to the cellular processes involved in producing RNA and proteins and as appropriate, secreting proteins, including where applicable, but not limited to, for example, transcription, translation, folding, modification and processing. "Expression products" include RNA transcribed from a gene and polypeptides obtained by translation of mRNA transcribed from a gene.

[0078] The term "genetically modified" or "engineered" cell as used herein refers to a cell into which an exogenous nucleic acid has been introduced by a process involving the hand of man (or a descendant of such a cell that has inherited at least a portion of the nucleic acid). The nucleic acid may for example contain a sequence that is exogenous to the cell, it may contain native sequences (i.e., sequences naturally found in the cells) but in a non-naturally occurring arrangement (e.g., a coding region linked to a promoter from a different gene), or altered versions of native sequences, etc. The process of transferring the nucleic into the cell can be achieved by any suitable technique. Suitable techniques include calcium phosphate or lipid-mediated transfection, electroporation, and transduction or infection using a viral vector. In some embodiments the polynucleotide or a portion thereof is integrated into the genome of the cell. The nucleic acid may have subsequently been removed or excised from the genome, provided that such removal or excision results in a detectable alteration in the cell relative to an unmodified but otherwise equivalent cell.

[0079] The term "identity" as used herein refers to the extent to which the sequence of two or more nucleic acids or polypeptides is the same. The percent identity between a sequence of interest and a second sequence over a window of evaluation, e.g., over the length of the sequence of interest, may be computed by aligning the sequences, determining the number of residues (nucleotides or amino acids) within the window of evaluation that are opposite an identical residue allowing the introduction of gaps to maximize identity, dividing by the total number of residues of the sequence of interest or the second sequence (whichever is greater) that fall within the window, and multiplying by 100. When computing the number of identical residues needed to achieve a particular percent identity, fractions are to be rounded to the nearest whole number. Percent identity can be calculated with the use of a variety of computer programs known in the art. For example, computer programs such as BLAST2, BLASTN, BLASTP, Gapped BLAST, etc., generate alignments and provide percent identity between sequences of interest. The algorithm of Karlin and Altschul (Karlin and Altschul, Proc. Natl. Acad. ScL USA 87:22264-2268, 1990) modified as in Karlin and Altschul, Proc. Natl. Acad. ScL USA 90:5873-5877, 1993 is incorporated into the NBLAST and XBLAST programs of Altschul et al. (Altschul, et al., J. Mol. Biol. 215:403-410, 1990). To obtain gapped alignments for comparison purposes, Gapped BLAST is utilized as described in Altschul et al. (Altschul, et al. Nucleic Acids Res. 25: 3389-3402, 1997). When utilizing BLAST and Gapped BLAST programs, the default parameters of the respective programs may be used. A PAM250 or BLOSUM62 matrix may be used. Software for performing BLAST analyses is publicly available through the National Center for Biotechnology Information (NCBI). See the Web site having URL www.ncbi.nlm.nih.gov for these programs. In a specific embodiment, percent identity is calculated using BLAST2 with default parameters as provided by the NCBI.

[0080] The term "isolated" or "partially purified" as used herein refers, in the case of a nucleic acid or polypeptide, to a nucleic acid or polypeptide separated from at least one other component (e.g., nucleic acid or polypeptide) that is present with the nucleic acid or polypeptide as found in its natural source and/or that would be present with the nucleic acid or polypeptide when expressed by a cell, or secreted in the case of secreted polypeptides. A chemically synthesized nucleic acid or polypeptide or one synthesized using in vitro transcription/translation is considered "isolated".

[0081] The term "isolated cell" as used herein refers to a cell that has been removed from an organism in which it was originally found or a descendant of such a cell. Optionally the cell has been cultured in vitro, e.g., in the presence of other cells. Optionally the cell is later introduced into a second organism or re-introduced into the organism from which it (or the cell from which it is descended) was isolated.

[0082] The term "isolated population" with respect to an isolated population of cells as used herein refers to a population of cells that has been removed and separated from a mixed or heterogeneous population of cells. In some embodiments, an isolated population is a substantially pure population of cells as compared to the heterogeneous population from which the cells were isolated or enriched from.

[0083] The term "substantially pure", with respect to a particular cell population, refers to a population of cells that is at least about 75%, preferably at least about 85%, more preferably at least about 90%, and most preferably at least about 95% pure, with respect to the cells making up a total cell population. Recast, the terms "substantially pure" or "essentially purified", with regard to a population of iMNs, refers to a population of cells that contain fewer than about 20%, more preferably fewer than about 15%, 10%, 8%, 7%, most preferably fewer than about 5%, 4%, 3%, 2%, 1%, or less than 1%, of cells that are not iMNs or their progeny as defined by the terms herein. In some embodiments, the present invention encompasses methods to expand a population of iMNs, wherein the expanded population of iMNs is a substantially pure population of iMNs.

[0084] The term "modulate" is used consistently with its use in the art, i.e., meaning to cause or facilitate a qualitative or quantitative change, alteration, or modification in a process, pathway, or phenomenon of interest. Without limitation, such change may be an increase, decrease, or change in relative strength or activity of different components or branches of the process, pathway, or

phenomenon. A "modulator" is an agent that causes or facilitates a qualitative or quantitative change, alteration, or modification in a process, pathway, or phenomenon of interest.

[0085] As used herein, the term "DNA" is defined as deoxyribonucleic acid.

[0086] As used herein, the term "gene" used herein can be a genomic gene comprising transcriptional and/or translational regulatory sequences and/or a coding region and/or non-translated sequences (e.g., introns, 5'- and 3'- untranslated sequences and regulatory sequences). The coding region of a gene can be a nucleotide sequence coding for an amino acid sequence or a functional RNA, such as tRNA, rRNA, catalytic RNA, siRNA, miRNA and antisense RNA. A gene can also be an mRNA or cDNA

corresponding to the coding regions (e.g. exons and miRNA) optionally comprising 5'- or 3' untranslated sequences linked thereto. A gene can also be an amplified nucleic acid molecule produced in vitro comprising all or a part of the coding region and/or 5'- or 3'- untranslated sequences linked thereto.

[0087] The term "polynucleotide" is used herein interchangeably with "nucleic acid" to indicate a polymer of nucleosides. Typically a polynucleotide of this invention is composed of nucleosides that are naturally found in DNA or RNA (e.g., adenosine, thymidine, guanosine, cytidine, uridine,

deoxyadenosine, deoxy thymidine, deoxy guanosine, and deoxycytidine) joined by phosphodiester bonds. However the term encompasses molecules comprising nucleosides or nucleoside analogs containing chemically or biologically modified bases, modified backbones, etc., whether or not found in naturally occurring nucleic acids, and such molecules may be preferred for certain applications. Where this application refers to a polynucleotide it is understood that both DNA, RNA, and in each case both single- and double-stranded forms (and complements of each single-stranded molecule) are provided. "Polynucleotide sequence" as used herein can refer to the polynucleotide material itself and/or to the sequence information (i.e. the succession of letters used as abbreviations for bases) that biochemically characterizes a specific nucleic acid. A polynucleotide sequence presented herein is presented in a 5' to 3' direction unless otherwise indicated. The terms "nucleic acid" can also refer to polynucleotides such as deoxyribonucleic acid (DNA), and, where appropriate, ribonucleic acid (RNA). The term should also be understood to include, as equivalents, analogs of either RNA or DNA made from nucleotide analogs, and, as applicable to the embodiment being described, single (sense or antisense) and double-stranded polynucleotides. The terms "polynucleotide sequence" and "nucleotide sequence" are also used interchangeably herein. Nucleic acids can be single stranded or double stranded, or can contain portions of both double stranded and single stranded sequence. The nucleic acid can be DNA, both genomic and cDNA, RNA, or a hybrid, where the nucleic acid can contain combinations of deoxyribo- and ribonucleotides, and combinations of bases including uracil, adenine, thymine, cytosine, guanine, inosine, xanthine hypoxanthine, isocytosine and isoguanine. Nucleic acids can be obtained by chemical synthesis methods or by recombinant methods.

[0088] A nucleic acid will generally contain phosphodiester bonds, although nucleic acid analogs can be included that can have at least one different linkage, e.g., phosphoramidate, phosphorothioate, phosphorodithioate, or O-methylphosphoroamidite linkages and peptide nucleic acid backbones and linkages. Other analog nucleic acids include those with positive backbones; non-ionic backbones, and non-ribose backbones, including those described in U.S. Pat. Nos. 5, 235,033 and 5, 034,506, which are incorporated by reference. Nucleic acids containing one or more non-naturally occurring or modified nucleotides are also included within one definition of nucleic acids. The modified nucleotide analog can be located for example at the 5'-end and/or the 3'-end of the nucleic acid molecule. Representative examples of nucleotide analogs can be selected from sugar- or backbone-modified ribonucleotides. It should be noted, however, that also nucleobase- modified ribonucleotides, i.e. ribonucleotides, containing a non naturally occurring nucleobase instead of a naturally occurring nucleobase such as uridines or cytidines modified at the 5-position, e.g. 5-(2-amino)propyl uridine, 5-bromo uridine;

adenosines and guanosines modified at the 8-position, e.g. 8- bromo guanosine; deaza nucleotides, e. g. 7 deaza-adenosine; O- and N- alkylated nucleotides, e.g. N6-methyl adenosine are suitable. The 2' OH- group can be replaced by a group selected from H. OR, R. halo, SH, SR, NH₂, NHR, NR₂ or CN, wherein R is C- C6 alkyl, alkenyl or alkynyl and halo is F. CI, Br or I. Modifications of the ribose- phosphate backbone can be done for a variety of reasons, e.g., to increase the stability and half- life of such molecules in physiological environments or as probes on a biochip. Mixtures of naturally occurring nucleic acids and analogs can be made; alternatively, mixtures of different nucleic acid analogs, and mixtures of naturally occurring nucleic acids and analogs can be made.

[0089] The terms "polypeptide" as used herein refers to a polymer of amino acids. The terms "protein" and "polypeptide" are used interchangeably herein. A peptide is a relatively short polypeptide, typically between about 2 and 60 amino acids in length. Polypeptides used herein typically contain amino acids such as the 20 L-amino acids that are most commonly found in proteins. However, other amino acids and/or amino acid analogs known in the art can be used. One or more of the amino acids in a polypeptide may be modified, for example, by the addition of a chemical entity such as a carbohydrate group, a phosphate group, a fatty acid group, a linker for conjugation, functionalization, etc. A polypeptide that has a non-polypeptide moiety covalently or non-covalently associated therewith is still considered a "polypeptide". Exemplary modifications include glycosylation and palmitoylation.

Polypeptides may be purified from natural sources, produced using recombinant DNA technology, synthesized through chemical means such as conventional solid phase peptide synthesis, etc. The term "polypeptide sequence" or "amino acid sequence" as used herein can refer to the polypeptide material itself and/or to the sequence information (i.e., the succession of letters or three letter codes used as abbreviations for amino acid names) that biochemically characterizes a polypeptide. A polypeptide sequence presented herein is presented in an N-terminal to C-terminal direction unless otherwise indicated.

[0090] The terms "polypeptide variant" refers to any polypeptide differing from a naturally occurring polypeptide by amino acid insertion(s), deletion(s), and/or substitution(s). Variants may be naturally occurring or created using, e g., recombinant DNA techniques or chemical synthesis. In some embodiments amino acid "substitutions" are the result of replacing one amino acid with another amino acid having similar structural and/or chemical properties, i.e., conservative amino acid replacements. "Conservative" amino acid substitutions may be made on the basis of similarity in any of a variety or properties such as side chain size, polarity, charge, solubility, hydrophobicity, hydrophilicity, and/or amphipathicity of the residues involved. For example, the non-polar (hydrophobic) amino acids include alanine, leucine, isoleucine, valine, glycine, proline, phenylalanine, tryptophan and methionine. The polar (hydrophilic), neutral amino acids include serine, threonine, cysteine, tyrosine, asparagine, and glutamine. The positively charged (basic) amino acids include arginine, lysine and histidine. The negatively charged (acidic) amino acids include aspartic acid and glutamic acid. Insertions or deletions may range in size from about 1 to 20 amino acids, e.g., 1 to 10 amino acids. In some instances larger domains may be removed without substantially affecting function. In certain embodiments of the invention the sequence of a variant can be obtained by making no more than a total of 5, 10, 15, or 20 amino acid additions, deletions, or substitutions to the sequence of a naturally occurring enzyme. In some embodiments not more than 1 %, 5%, 10%, 15% or 20% of the amino acids in a polypeptide are insertions, deletions, or substitutions relative to the original polypeptide. Guidance in determining which amino acid residues may be replaced, added, or deleted without eliminating or substantially reducing activities of interest, may be obtained by comparing the sequence of the particular polypeptide with that of homologous polypeptides (e.g., from other organisms) and minimizing the number of amino acid sequence changes made in regions of high homology (conserved regions) or by replacing amino acids with those found in homologous sequences since amino acid residues that are conserved among various species are more likely to be important for activity than amino acids that are not conserved.

[0091] By "amino acid sequences substantially homologous" to a particular amino acid sequence (e.g. Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl) is meant polypeptides that include one or more additional amino acids, deletions of amino acids, or substitutions in the amino acid sequence of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl without appreciable loss of functional activity as compared to wild-type Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides in terms of the ability to produce iMNs from a somatic cell, e.g., fibroblast. For example, the deletion can consist of amino acids that are not essential to the presently defined differentiating activity and the substitution(s) can be conservative (i.e., basic, hydrophilic, or hydrophobic amino acids substituted for the same). Thus, it is understood that, where desired, modifications and changes may be made in the amino acid sequence of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl, and a protein having like characteristics still obtained. It is thus contemplated that various changes may be made in the amino acid sequence of the Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl amino acid sequence (or underlying nucleic acid sequence) without appreciable loss of biological utility or activity and possibly with an increase in such utility or activity. In some embodiments, the amino acid sequences substantially homologous to a particular amino acid sequence are at least 70%, e.g., 75%, 80%85%, 90%, 95% or another percent from 70% to 100%, in intergers thereof, identical to the particular amino acid sequence.

[0092] As used herein, "Lhx3" is refers to the Lhx3 protein of Genebank accession No: NP_055379.1 (SEQ ID NO: 1); (human) NP_001034742.1 (SEQ ID NO: 2) (mouse) encoded by genes NM_014564 (SEQ ID NO: 17) (human) NM_001039653.1 (SEQ ID NO: 18) (mouse). The term Lhx3 also encompasses species variants, homologues, allelic forms, mutant forms, and equivalents thereof, including conservative substitutions, additions, deletions therein not adversely affecting the structure of function. Lhx3 is referred in the art as aliases; Homo sapiens LIM homeobox 3 (LHX3), transcript variant 2, mRNA, CPHD3; LIM3; M2-LHX3. In addition to naturally-occurring allelic variants of the Lhx3 sequences that may exist in the population, it will be appreciated that, as is the case for virtually all proteins, a variety of changes can be introduced into the sequences of SEQ ID NO: 1 or SEQ ID NO: 2 (referred to as "wild type" sequences) without substantially altering the functional (biological) activity of the polypeptides. Such variants are included within the scope of the terms "Lhx3", "Lhx3 protein", etc.

[0093] As used herein, "Ascll" is refers to the Ascll protein of Genebank accession No: NP_004307.2 (SEQ ID NO: 3) (human), or NP_032579.2 (SEQ ID NO: 4) (mouse) and is encoded by genes

NM_004316.3 (SEQ ID NO: 19) (human) or NM_008553.4 (SEQ ID NO:20) (mouse), respectively. The term Ascll also encompasses species variants, homologues, allelic forms, mutant forms, and equivalents thereof, including conservative substitutions, additions, deletions therein not adversely affecting the structure of function. Ascll is referred in the art as aliases; Homo sapiens achaete-scute complex homolog 1 (Drosophila) (ASCL1), ASH1 ; bHLHa46; HASH1 ; MASH1. In addition to naturally-occurring allelic variants of the Ascll sequences that may exist in the population, it will be appreciated that, as is the case for virtually all proteins, a variety of changes can be introduced into the sequences of SEQ ID NO: 3 or SEQ ID NO: 4 (referred to as "wild type" sequences) without substantially altering the functional (biological) activity of the polypeptides. Such variants are included within the scope of the terms " Ascll", " Ascll protein", etc.

[0094] As used herein, "Brn2" is refers to the Brn2 protein of Genebank accession No: NP_005595.2 (SEQ ID NO: 5) (human) or NP_032925.1 (SEQ ID NO: 6) (mouse) and encodded by genes

NM_005604.2 (SEQ ID NO: 21) (human) or NM_008899.1 (SEQ ID NO: 22) (mouse), respectively. The term Brn2 also encompasses species variants, homologues, allelic forms, mutant forms, and equivalents thereof, including conservative substitutions, additions, deletions therein not adversely affecting the structure of function. Brn2 is referred in the art as aliases; POU3F2, POU class 3 homeobox 2, BRN2, OCT7, POUF3. In addition to naturally-occurring allelic variants of the Brn2 sequences that may exist in the population, it will be appreciated that, as is the case for virtually all proteins, a variety of changes can be introduced into the sequences of SEQ ID NO: 5 or SEQ ID NO: 6 (referred to as "wild type" sequences) without substantially altering the functional (biological) activity of the polypeptides. Such variants are included within the scope of the terms "Brn2", "Brn2 protein", etc.

[0095] As used herein, "Mytll " is refers to the Mytll protein of Genebank accession No: NP_055840.2 (SEQ ID NO: 7) (human) or NP_001087244.1 (SEQ ID NO: 8) (mouse) and encoded by genes

NM_015025.2 (SEQ ID NO: 23) (human) or NM_001093775.1 (SEQ ID NO: 24) (mouse), respectively. The term Mytll also encompasses species variants, homologues, allelic forms, mutant forms, and equivalents thereof, including conservative substitutions, additions, deletions therein not adversely affecting the structure of function. Mytll is referred in the art as aliases; myelin transcription factor 1- like (MYT1L), KIAA1106, "neural zinc finger transcription factor 1 ", NZF1. In addition to naturally- occurring allelic variants of the Mytll sequences that may exist in the population, it will be appreciated that, as is the case for virtually all proteins, a variety of changes can be introduced into the sequences of SEQ ID NO: 7 or SEQ ID NO: 8 (referred to as "wild type" sequences) without substantially altering the functional (biological) activity of the polypeptides. Such variants are included within the scope of the terms "Mytll ", " Mytll protein", etc.

[0096]As used herein, "Isll" is refers to the Isll protein of Genebank accession No: NP_002193.2 (SEQ ID NO: 9) (human) or NP_067434.3 (SEQ ID NO: 10) (mouse) and is encoded by genes

NM_002202.2 (SEQ ID NO: 25) (human) or NM_021459.4 (SEQ ID NO: 26) (mouse) respectively. The term Isll also encompasses species variants, homologues, allelic forms, mutant forms, and equivalents thereof, including conservative substitutions, additions, deletions therein not adversely affecting the structure of function. Isll is referred in the art as aliases; ISL LIM homeobox 1, Isl-1, ISLET 1. In addition to naturally-occurring allelic variants of the Isll sequences that may exist in the population, it will be appreciated that, as is the case for virtually all proteins, a variety of changes can be introduced into the sequences of SEQ ID NO: 9 or SEQ ID NO: 10 (referred to as "wild type" sequences) without substantially altering the functional (biological) activity of the polypeptides. Such variants are included within the scope of the terms "Isll", "Isll protein", etc.

[0097] As used herein, "Hb9" is refers to the Hb9 protein of Genebank accession No: NP_001158727.1 (SEQ ID NO: 11) (human) or NP_064328.2 (SEQ ID NO: 12) (mouse) and encoded by genes

NM_001165255.1 (SEQ ID NO: 27) (human) or NM_019944.2 (SEQ ID NO: 28) (mouse) respectively. The term Hb9 also encompasses species variants, homologues, allelic forms, mutant forms, and equivalents thereof, including conservative substitutions, additions, deletions therein not adversely affecting the structure of function. Hb9 is referred in the art as aliases; motor neuron and pancreas homeobox 1, MNX1, HB9, HOXHB9, SCRA1. In addition to naturally-occurring allelic variants of the H 9sequences that may exist in the population, it will be appreciated that, as is the case for virtually all proteins, a variety of changes can be introduced into the sequences of SEQ ID NO: 11 or SEQ ID NO: 12 (referred to as "wild type" sequences) without substantially altering the functional (biological) activity of the polypeptides. Such variants are included within the scope of the terms "Hb9", "Hb9 protein", etc.

[0098] As used herein, "Ngn2" is refers to the Ngn2 protein of Genebank accession No: NP_076924.1 (SEQ ID NO: 13) (human) or NP_033848.1 (SEQ ID NO: 14) (mouse) and are encoded by

NM_024019.2 (SEQ ID NO: 29) (human) or NM_009718.2 (SEQ ID NO: 30) (mouse), respectively. The term Ng«2 also encompasses species variants, homologues, allelic forms, mutant forms, and equivalents thereof, including conservative substitutions, additions, deletions therein not adversely affecting the structure of function. Ngn2 is referred in the art as aliases; Neurogenin 2 (NEUROG2), Atoh4, bHLHa8, Math4A, ngn-2. In addition to naturally-occurring allelic variants of the Ngn2 sequences that may exist in the population, it will be appreciated that, as is the case for virtually all proteins, a variety of changes can be introduced into the sequences of SEQ ID NO: 13 or SEQ ID NO: 14 (referred to as "wild type" sequences) without substantially altering the functional (biological) activity of the polypeptides. Such variants are included within the scope of the terms "Ngn2", " Ngn2 protein", etc.

[0099] As used herein, "NeuroDl" is refers to the NewroDiprotein of Genebank accession No:

NP 002491.2 (SEQ ID NO: 15) (human) or NP_035024.1 (SEQ ID NO: 16) (mouse) and encoded by genes NM_002500.3 (SEQ ID NO: 31) (human) or NM_010894.2 (SEQ ID NO: 32) (mouse), respectively. The term NeuroDl also encompasses species variants, homologues, allelic forms, mutant forms, and equivalents thereof, including conservative substitutions, additions, deletions therein not adversely affecting the structure of function. NeuroDlis referred in the art as aliases; neurogenic differentiation 1, beta-cell E-box transactivator 2", BETA2, BHF-1, bHLHa3, MODY6, NeuroD, "neurogenic helix-loop-helix protein NEUROD". In addition to naturally-occurring allelic variants of the NeuroDl sequences that may exist in the population, it will be appreciated that, as is the case for virtually all proteins, a variety of changes can be introduced into the sequences of SEQ ID NO: 15 or SEQ ID NO: 16 (referred to as "wild type" sequences) without substantially altering the functional (biological) activity of the polypeptides. Such variants are included within the scope of the terms "NeuroDl", " NeuroDl protein", etc.

[00100] The term a "variant" in referring to a polypeptide could be, e.g., a polypeptide at least 80%, 85%, 90%, 95%, 98%, or 99% identical to full length polypeptide. The variant could be a fragment of full length polypeptide, e.g., a fragment of at least 10 or at least 20 contagious amino acids of the wild type version of the polypeptide. In some embodiments, a variant is a naturally occurring splice variant. The variant could be a polypeptide at least 80%, 85%, 90%, 95%, 98%, or 99% identical to a fragment of the polypeptide, wherein the fragment is at least 50%, 60%, 70%, 80%, 85%, 90%, 95%, 98%, or 99% as long as the full length wild type polypeptide or a domain thereof having an activity of interest such as the ability to directly convert fibroblasts to iMNs. In some embodiments the domain is at least 100, 200, 300, or 400 amino acids in length, beginning at any amino acid position in the sequence and extending toward the C-terminus. Variations known in the art to eliminate or substantially reduce the activity of the protein are preferably avoided. In some embodiments, the variant lacks an N- and/or C- terminal portion of the full length polypeptide, e.g., up to 10, 20, or 50 amino acids from either terminus is lacking. In some embodiments the polypeptide has the sequence of a mature (full length) polypeptide, by which is meant a polypeptide that has had one or more portions such as a signal peptide removed during normal intracellular proteolytic processing (e.g., during co-translational or post-translational processing). In some embodiments wherein the protein is produced other than by purifying it from cells that naturally express it, the protein is a chimeric polypeptide, by which is meant that it contains portions from two or more different species. In some embodiments wherein a protein is produced other than by purifying it from cells that naturally express it, the protein is a derivative, by which is meant that the protein comprises additional sequences not related to the protein so long as those sequences do not substantially reduce the biological activity of the protein.

[00101] One of skill in the art will be aware of, or will readily be able to ascertain, whether a particular polypeptide variant, fragment, or derivative is functional using assays known in the art. For example, the ability of a variant of a Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides of SEQ ID NOs: 1-16 to convert a somatic cell, e.g., fibroblast to a iMN can be assessed using the assays as disclose herein in the Examples. Other convenient assays include measuring the ability to activate transcription of a reporter construct containing a Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl binding site operably linked to a nucleic acid sequence encoding a detectable marker such as luciferase. One assay involves determining whether the Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl variant induces a somatic cell, e.g., fibroblast to become a iMN or express markers of a motor neuron or exhibit functional characteristics of a motor neuron as disclosed herein. Determination of such expression of MN markers can be determined using any suitable method, e.g., immunoblotting. Such assays may readily be adapted to identify or confirm activity of agents that directly convert a somatic cell, e.g., fibroblast to a iMN. In certain embodiments of the invention a functional variant or fragment has at least 50%, 60%, 70%, 80%, 90%, 95% or more of the activity of the full length wild type polypeptide.

[00102] The term " functional fragments" as used herein regarding Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides having amino acid sequences substantially homologous thereto means a polypeptide sequence of at least 5 contiguous amino acids of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl sequences of SEQ ID NO: 1-16 having amino acid sequences substantially homologous thereto, wherein the functional fragment polypeptide sequence is about at least 50%, or 60% or 70% or at 80% or 90% or 100% or greater, for example 1.5-fold, 2-fold, 3-fold, 4-fold or greater than 4-fold as effective at direct conversion of a somatic cell, e.g., fibroblast to a iMN as the corresponding wild type Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides of SEQ ID NO: 1-16, respectively as described herein. The functional fragment polypeptide may have additional functions that can include decreased antigenicity, increased DNA binding (as in transcription factors), or altered RNA binding (as in regulating RNA stability or degradation).

[00103] The term "vector" refers to a carrier DNA molecule into which a DNA sequence can be inserted for introduction into a host cell. Preferred vectors are those capable of autonomous replication and/or expression of nucleic acids to which they are linked. Vectors capable of directing the expression of genes to which they are operatively linked are referred to herein as "expression vectors". Thus, an "expression vector" is a specialized vector that contains the necessary regulatory regions needed for expression of a gene of interest in a host cell. In some embodiments the gene of interest is operably linked to another sequence in the vector. Vectors can be viral vectors or non-viral vectors. Should viral vectors be used, it is preferred the viral vectors are replication defective, which can be achieved for example by removing all viral nucleic acids that encode for replication. A replication defective viral vector will still retain its infective properties and enters the cells in a similar manner as a replicating adenoviral vector, however once admitted to the cell a replication defective viral vector does not reproduce or multiply. Vectors also encompass liposomes and nanoparticles and other means to deliver DNA molecule to a cell.

[00104] The term "operably linked" means that the regulatory sequences necessary for expression of the coding sequence are placed in the DNA molecule in the appropriate positions relative to the coding sequence so as to effect expression of the coding sequence. This same definition is sometimes applied to the arrangement of coding sequences and transcription control elements (e.g. promoters, enhancers, and termination elements) in an expression vector. The term "operatively linked" includes having an appropriate start signal (e.g., ATG) in front of the polynucleotide sequence to be expressed, and maintaining the correct reading frame to permit expression of the polynucleotide sequence under the control of the expression control sequence, and production of the desired polypeptide encoded by the polynucleotide sequence.

[00105] The term "viral vectors" refers to the use of viruses, or virus-associated vectors as carriers of a nucleic acid construct into a cell. Constructs may be integrated and packaged into non-replicating, defective viral genomes like Adenovirus, Adeno-associated virus (AAV), or Herpes simplex virus (HSV) or others, including reteroviral and lentiviral vectors, for infection or transduction into cells. The vector may or may not be incorporated into the cell's genome. The constructs may include viral sequences for transfection, if desired. Alternatively, the construct may be incorporated into vectors capable of episomal replication, e.g. EPV and EBV vectors.

[00106] As used herein, the term "adenovirus" refers to a virus of the family Adenovirida. Adenoviruses are medium-sized (90-100 nm), nonenveloped (naked) icosahedral viruses composed of a nucleocapsid and a double-stranded linear DNA genome.

[00107] As used herein, the term "non -integrating viral vector" refers to a viral vector that does not integrate into the host genome; the expression of the gene delivered by the viral vector is temporary. Since there is little to no integration into the host genome, non-integrating viral vectors have the advantage of not producing DNA mutations by inserting at a random point in the genome. For example, a non-integrating viral vector remains extra-chromosomal and does not insert its genes into the host genome, potentially disrupting the expression of endogenous genes. Non-integrating viral vectors can include, but are not limited to, the following: adenovirus, alphavirus, picornavirus, and vaccinia virus. These viral vectors are "non-integrating" viral vectors as the term is used herein, despite the possibility that any of them may, in some rare circumstances, integrate viral nucleic acid into a host cell's genome. What is critical is that the viral vectors used in the methods described herein do not, as a rule or as a primary part of their life cycle under the conditions employed, integrate their nucleic acid into a host cell's genome. It goes without saying that an iPS cell generated by a non-integrating viral vector will not be administered to a subject unless it and its progeny are free from viral remnants.

[00108] As used herein, the term "viral remnants" refers to any viral protein or nucleic acid sequence introduced using a viral vector. Generally, integrating viral vectors will incorporate their sequence into the genome; such sequences are referred to herein as a "viral integration remnant". However, the temporary nature of a non-integrating virus means that the expression, and presence of, the virus is temporary and is not passed to daughter cells. Thus, upon passaging of a re-programmed cell the viral remnants of the non-integrating virus are essentially removed.

[00109] As used herein, the term "free of viral integration remnants" and "substantially free of viral integration remnants" refers to iPS cells that do not have detectable levels of an integrated adenoviral genome or an adenoviral specific protein product (i.e., a product other than the gene of interest), as assayed by PCR or immunoassay. Thus, the iPS cells that are free (or substantially free) of viral remnants have been cultured for a sufficient period of time that transient expression of the adenoviral vector leaves the cells substantially free of viral remnants.

[00110] The terms "regulatory sequence" and "promoter" are used interchangeably herein, and refer to nucleic acid sequences, such as initiation signals, enhancers, and promoters, which induce or control transcription of protein coding sequences with which they are operatively linked. In some examples, transcription of a recombinant gene is under the control of a promoter sequence (or other transcriptional regulatory sequence) which controls the expression of the recombinant gene in a cell- type in which expression is intended. It will also be understood that the recombinant gene can be under the control of transcriptional regulatory sequences which are the same or which are different from those sequences which control transcription of the naturally-occurring form of a protein. In some instances the promoter sequence is recognized by the synthetic machinery of the cell, or introduced synthetic machinery, required for initiating transcription of a specific gene.

[00111] As used herein, the term "tissue-specific promoter" means a nucleic acid sequence that serves as a promoter, i.e., regulates expression of a selected nucleic acid sequence operably linked to the promoter, and which selectively affects expression of the selected nucleic acid sequence in specific cells of a tissue, such as cells of neural origin, e.g. neuronal cells. The term also covers so-called "leaky" promoters, which regulate expression of a selected nucleic acid primarily in one tissue, but cause lesser expression in other tissues as well.

[00112] The term "phenotype" refers to one or a number of total biological characteristics that define the cell or organism under a particular set of environmental conditions and factors, regardless of the actual genotype.

[00113] The term "statistically significant" or "significantly" refers to statistical significance and generally means a two standard deviation (2SD) below normal, or lower, concentration of the marker. The term refers to statistical evidence that there is a difference. It is defined as the probability of making a decision to reject the null hypothesis when the null hypothesis is actually true. The decision is often made using the p-value.

[00114] As used herein, "the presence of lower amounts of a marker in the iMN as compared to the somatic cell, e.g., fibroblast from which the iMN was derived" refers to an amount of a marker protein or gene product (e.g. mRNA) that is significantly decreased in the iMN as compared to the amount of the same marker present in the somatic cell, e.g., fibroblast from which is was derived. The term "significantly decreased" means that the differences between the compared levels is statistically significant. The levels of the marker level can be represented by arbitrary units, for example as units obtained from a densitometer, luminometer, or an Elisa plate reader. As a non-limiting example, a iMN has significantly decreased levels of Snaill, thyl, Fspl expression as compared to a fibroblast from which it was derived.

[00115] As used herein, "the presence of higher amounts of a marker in the iMN as compared to the somatic cell, e.g., fibroblast from which is was derived" refers to an amount of a marker protein or gene product (e.g. mRNA) that is significantly increased in the iMN as compared to the amount of the same marker present in the somatic cell, e.g., fibroblast from which is was derived. The phrase "significantly increased" means that the differences between the compared levels is statistically significant. The levels of the marker level can be represented by arbitrary units, for example as units obtained from a densitometer, luminometer, or an Elisa plate reader. As a non-limiting example, a iMN has significantly increased levels of P2-tubilins (e.g, Tubb2a and Tubb2b), Map2, synapsins (e.g., Synl and Syn2), synaptophysin, synaptotagmins (e.g., Sytl, Syt4, Sytl3, Syt 16), NeuroD, Ml, cholineacetyltransferase (ChAT), e.g., vascular ChAT (VChAT) as compared to a fibroblast from which it was derived.

[00116] As used herein, the term "transcription factor" refers to a protein that binds to specific parts of DNA using DNA binding domains and is part of the system that controls the transfer (or transcription) of genetic information from DNA to RNA.

[00117] As used herein, "proliferating" and "proliferation" refer to an increase in the number of cells in a population (growth) by means of cell division. Cell proliferation is generally understood to result from the coordinated activation of multiple signal transduction pathways in response to the environment, including growth factors and other mitogens. Cell proliferation may also be promoted by release from the actions of intra- or extracellular signals and mechanisms that block or negatively affect cell proliferation.

[00118] The terms "enriching" or "enriched" are used interchangeably herein and mean that the yield (fraction) of cells of one type is increased by at least 10% over the fraction of cells of that type in the starting culture or preparation.

[00119] The terms "renewal" or "self-renewal" or "proliferation" are used interchangeably herein, are used to refer to the ability of stem cells to renew themselves by dividing into the same non-specialized cell type over long periods, and/or many months to years. In some instances, proliferation refers to the expansion of cells by the repeated division of single cells into two identical daughter cells.

[00120] The term "lineages" as used herein describes a cell with a common ancestry or cells with a common developmental fate. In the context of a cell that is of "neuronal linage" this means the cell can differentiate along the neuronal lineage restricted pathways.

[00121] The terms "decrease" , "reduced", "reduction" , "decrease" or "inhibit" are all used herein generally to mean a decrease by a statistically significant amount. However, for avoidance of doubt, ""reduced", "reduction" or "decrease" or "inhibit" means a decrease by at least 10% as compared to a reference level, for example a decrease by at least about 20%, or at least about 30%, or at least about 40%, or at least about 50%, or at least about 60%, or at least about 70%, or at least about 80%, or at least about 90% or up to and including a 100% decrease (i.e. absent level as compared to a reference sample), or any decrease between 10-100% as compared to a reference level.

[00122] The terms "increased" 'increase" or "enhance" or "activate" are all used herein to generally mean an increase by a statically significant amount; for the avoidance of any doubt, the terms

"increased", "increase" or "enhance" or "activate" means an increase of at least 10% as compared to a reference level, for example an increase of at least about 20%, or at least about 30%, or at least about 40%, or at least about 50%, or at least about 60%, or at least about 70%, or at least about 80%, or at least about 90% or up to and including a 100% increase or any increase between 10-100% as compared to a reference level, or at least about a 2-fold, or at least about a 3-fold, or at least about a 4-fold, or at least about a 5 -fold or at least about a 10-fold increase, or any increase between 2-fold and 10-fold or greater as compared to a reference level.

[00123] As used herein, the term "xenogeneic" refers to cells that are derived from different species.

[00124] The term "iMN inducing factor" refers to a gene, RNA, or protein that promotes or contributes to direct conversion or transdifferentiation of a somatic cell to a iMN. In aspects of the invention relating to reprogramming factor(s), the invention provides embodiments in which the iMN-inducing factors of interest for transdifferentiation of somatic cells to iMN in vitro.

[00125] A "marker" as used herein is used to describe the characteristics and/or phenotype of a cell. Markers can be used for selection of cells comprising characteristics of interests. Markers will vary with specific cells. Markers are characteristics, whether morphological, functional or biochemical

(enzymatic) characteristics of the cell of a particular cell type, or molecules expressed by the cell type. Preferably, such markers are proteins, and more preferably, possess an epitope for antibodies or other binding molecules available in the art. However, a marker may consist of any molecule found in a cell including, but not limited to, proteins (peptides and polypeptides), lipids, polysaccharides, nucleic acids and steroids. Examples of morphological characteristics or traits include, but are not limited to, shape, size, and nuclear to cytoplasmic ratio. Examples of functional characteristics or traits include, but are not limited to, the ability to adhere to particular substrates, ability to incorporate or exclude particular dyes, ability to migrate under particular conditions, and the ability to differentiate along particular lineages. Markers may be detected by any method available to one of skill in the art. Markers can also be the absence of a morphological characteristic or absence of proteins, lipids etc. Markers can be a combination of a panel of unique characteristics of the presence and absence of polypeptides and other morphological characteristics.

[00126] The term "selectable marker" refers to a gene, RNA, or protein that when expressed, confers upon cells a selectable phenotype, such as resistance to a cytotoxic or cytostatic agent (e.g., antibiotic resistance), nutritional prototrophy, or expression of a particular protein that can be used as a basis to distinguish cells that express the protein from cells that do not. Proteins whose expression can be readily detected such as a fluorescent or luminescent protein or an enzyme that acts on a substrate to produce a colored, fluorescent, or luminescent substance ("detectable markers") constitute a subset of selectable markers. The presence of a selectable marker linked to expression control elements native to a gene that is normally expressed selectively or exclusively in pluripotent cells makes it possible to identify and select somatic cells that have been reprogrammed to a pluripotent state. A variety of selectable marker genes can be used, such as neomycin resistance gene (neo), puromycin resistance gene (puro), guanine phosphoribosyl transferase (gpt), dihydrofolate reductase (DHFR), adenosine deaminase (ada), puromycin-N- acetyltransferase (PAC), hygromycin resistance gene (hyg), multidrug resistance gene (mdr), thymidine kinase (TK), hypoxanthine-guanine phosphoribosyltransf erase (HPRT), and hisD gene. Detectable markers include green fluorescent protein (GFP) blue, sapphire, yellow, red, orange, and cyan fluorescent proteins and variants of any of these. Luminescent proteins such as lucif erase (e.g., firefly or Renilla luciferase) are also of use. As will be evident to one of skill in the art, the term

"selectable marker" as used herein can refer to a gene or to an expression product of the gene, e.g., an encoded protein.

[00127] In some embodiments the selectable marker confers a proliferation and/or survival advantage on cells that express it relative to cells that do not express it or that express it at significantly lower levels. Such proliferation and/or survival advantage typically occurs when the cells are maintained under certain conditions, i.e., "selective conditions". To ensure an effective selection, a population of cells can be maintained for a under conditions and for a sufficient period of time such that cells that do not express the marker do not proliferate and/or do not survive and are eliminated from the population or their number is reduced to only a very small fraction of the population. The process of selecting cells that express a marker that confers a proliferation and/or survival advantage by maintaining a population of cells under selective conditions so as to largely or completely eliminate cells that do not express the marker is referred to herein as "positive selection", and the marker is said to be "useful for positive selection". Negative selection and markers useful for negative selection are also of interest in certain of the methods described herein. Expression of such markers confers a proliferation and/or survival disadvantage on cells that express the marker relative to cells that do not express the marker or express it at significantly lower levels (or, considered another way, cells that do not express the marker have a proliferation and/or survival advantage relative to cells that express the marker). Cells that express the marker can therefore be largely or completely eliminated from a population of cells when maintained in selective conditions for a sufficient period of time.

[00128] A "reporter gene" as used herein encompasses any gene that is genetically introduced into a cell that adds to the phenotype of the stem cell. Reporter genes as disclosed in this invention are intended to encompass fluorescent, luminescent, enzymatic and resistance genes, but also other genes which can easily be detected by persons of ordinary skill in the art. In some embodiments of the invention, reporter genes are used as markers for the identification of particular stem cells, cardiovascular stem cells and their differentiated progeny. A reporter gene is generally operatively linked to sequences that regulate its expression in a manner dependent upon one or more conditions which are monitored by measuring expression of the reporter gene. In some cases, expression of the reporter gene may be determined in live cells. Where live cell reporter gene assays are used, reporter gene expression may be monitored at multiple timepoints, e.g., 2, 3, 4, 5, 6, 8, or 10 or more timepoints. In some cases, where a live cell reporter assay is used, reporter gene expression is monitored with a frequency of at least about 10 minutes to about 24 hours, e.g., 20 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, 10 hours, 12 hours, 18 hours, or another frequency from any integer between about 10 minutes to about 24 hours.

[00129] The terms "subject" and "individual" are used interchangeably herein, and refer to an animal, for example, a human from whom cells can be obtained and/or to whom treatment, including prophylactic treatment, with the cells as described herein, is provided. For treatment of those conditions or disease states which are specific for a specific animal such as a human subject, the term subject refers to that specific animal. The "non-human animals" and "non-human mammals" as used interchangeably herein, includes mammals such as rats, mice, rabbits, sheep, cats, dogs, cows, pigs, and non-human primates. The term "subject" also encompasses any vertebrate including but not limited to mammals, reptiles, amphibians and fish. However, advantageously, the subject is a mammal such as a human, or other mammals such as a domesticated mammal, e.g. dog, cat, horse, and the like, or production mammal, e.g. cow, sheep, pig, and the like.

[00130] The terms "treat", "treating", "treatment", etc., as applied to an isolated cell, include subjecting the cell to any kind of process or condition or performing any kind of manipulation or procedure on the cell. As applied to a subject, the term "treating" refer to providing medical or surgical attention, care, or management to an individual. The individual is usually ill or injured, or at increased risk of becoming ill relative to an average member of the population and in need of such attention, care, or management.

[00131] In some embodiments, the term "treating" and "treatment" refers to administering to a subject an effective amount of a composition, e.g., a composition comprising iMN or their differentiated progeny so that the subject as a reduction in at least one symptom of the disease or an improvement in the disease, for example, beneficial or desired clinical results. For purposes of this invention, beneficial or desired clinical results include, but are not limited to, alleviation of one or more symptoms,

diminishment of extent of disease, stabilized (i.e., not worsening) state of disease, delay or slowing of disease progression, amelioration or palliation of the disease state, and remission (whether partial or total) , whether detectable or undetectable. Treating can refer to prolonging survival as compared to expected survival if not receiving treatment. Thus, one of skill in the art realizes that a treatment may improve the disease condition, but may not be a complete cure for the disease. In some embodiments, treatment can be "prophylaxic treatment, where the subject is administered a composition as disclosed herein (e.g., a population of iMN or their progeny) to a subject at risk of developing a motor neuron disease as disclosed herein. In some embodiments, treatment is "effective" if the progression of a disease is reduced or halted. Those in need of treatment include those already diagnosed with a motor neuron disease or disorder, e.g., ALS or SMA, as well as those likely to develop a motor neuron disease or disorder due to genetic susceptibility or other factors such as family history of motor neuron disease, exposure to susceptibility factors, weight, diet and health.

[00132] As used herein, the terms "administering," "introducing" and "transplanting" are used interchangeably in the context of the placement of iMNs of the invention into a subject, by a method or route which results in at least partial localization of the iMN at a desired site. In some embodiments, the iMNs can be placed directly in the spinal cord or in the cerebellum, or alternatively be administered by any appropriate route which results in delivery to a desired location in the subject where at least a portion of the cells or components of the cells remain viable. The period of viability of the cells after administration to a subject can be as short as a few hours, e. g. twenty-four hours, to a few days, to as long as several or more years.

[00133] The phrases "parenteral administration" and "administered parenterally" as used herein means modes of administration other than enteral and topical administration, usually by injection, and includes, without limitation, intravenous, intramuscular, intraarterial, intrathecal, intraventricular, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, sub capsular, subarachnoid, intraspinal, intracerebro spinal, and intrasternal injection and infusion. The phrases "systemic administration," "administered systemically", "peripheral

administration" and "administered peripherally" as used herein mean the administration of

cardiovascular stem cells and/or their progeny and/or compound and/or other material other than directly into the central nervous system, such that it enters the animal's system and, thus, is subject to metabolism and other like processes, for example, subcutaneous administration. [00134] The term "tissue" refers to a group or layer of specialized cells which together perform certain special functions. The term "tissue-specific" refers to a source of cells from a specific tissue.

[00135] As used herein the term "comprising" or "comprises" is used in reference to compositions, methods, and respective component(s) thereof, that are essential to the invention, yet open to the inclusion of unspecified elements, whether essential or not.

[00136] As used herein the term "consisting essentially of" refers to those elements required for a given embodiment. The term permits the presence of additional elements that do not materially affect the basic and novel or functional characteristic(s) of that embodiment of the invention.

[00137] The term "consisting of" refers to compositions, methods, and respective components thereof as described herein, which are exclusive of any element not recited in that description of the embodiment.

[00138] As used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural references unless the context clearly dictates otherwise. Thus for example, references to "the method" includes one or more methods, and/or steps of the type described herein and/or which will become apparent to those persons skilled in the art upon reading this disclosure and so forth.

[00139] It is understood that the foregoing detailed description and the following examples are illustrative only and are not to be taken as limitations upon the scope of the invention. Various changes and modifications to the disclosed embodiments, which will be apparent to those of skill in the art, may be made without departing from the spirit and scope of the present invention. Further, all patents, patent applications, and publications identified are expressly incorporated herein by reference for the purpose of describing and disclosing, for example, the methodologies described in such publications that might be used in connection with the present invention. These publications are provided solely for their disclosure prior to the filing date of the present application. Nothing in this regard should be construed as an admission that the inventors are not entitled to antedate such disclosure by virtue of prior invention or for any other reason. All statements as to the date or representation as to the contents of these documents are based on the information available to the applicants and do not constitute any admission as to the correctness of the dates or contents of these documents.

Direct Reprogramming (transdifferentiation):

[00140] The process of altering the cell phenotype of a differentiated cell (i.e. a first cell), e.g., altering the phenotype of a somatic cell to a differentiated cell of a different phenotype (i.e. a second cell) without the first differentiated cell being completely reprogrammed to a less differentiated phenotype intermediate is referred to as "direct reprogramming" or "transdifferentiation". Stated another way, cells of one type can be converted to another type in a process by what is commonly referred to in the art as transdifferentiation, cellular reprogramming or lineage reprogramming.

[00141] Transdifferentiation encompasses a process of switching the phenotype of a first differentiated cell to the phenotype of a second different differentiated cell, without the complete reversal of the differentiation state of the somatic cell, and is different from "reprogramming a cell to a pluripotent state" which typically refers to a process which partially or completely reverses the differentiation state of a somatic cell to a cell with a stem cell-like phenotype, e.g., to an induced pluripotent stem cell (iPSC).

[00142] As disclosed herein, the present invention relates to compositions and methods for the direct conversion of a somatic cell, e.g., a fibroblast to a functional motor neuron, referred to herein as an "induced motor neuron (iMN)". In certain embodiments of the invention, the transdifferentiation of a somatic cell, e.g., fibroblast causes the somatic cell to assume a MN like state, without being completely reprogrammed to a pluripotent state prior to becoming an iMN.

[00143] In some embodiments, the methods and compositions of the present invention can be practiced on somatic cells that are fully differentiated and/or restricted to giving rise only to cells of that particular type. The somatic cells can be either partially or terminally differentiated prior to direct conversion to iMNs. In some embodiments, somatic cells which are trandifferentiated into iMNs are fibroblast cells.

[00144] The present invention relates to compositions and methods for direct conversion of a somatic cell, e.g., a fibroblast to a functional motor neuron. In some embodiments, the present invention provides methods for direct conversion of fibroblasts to a different phenotype, such as an iMN.

Direct conversion of fibroblasts to iMNs

[00153] The present invention relates to a method of trandifferentiating somatic cells, e.g., fibroblasts to motor neurons, referred to herein as iMNs (induced motor neurons). In some embodiments, a somatic cell, e.g., fibroblast are the preferred starting material. In some embodiments, a population of iMNs are produced by increasing the protein expression of at least three transcription factors selected from Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl in a somatic cell, e.g., fibroblast. In alternative embodiments, the population of a somatic cell, e.g., fibroblast can comprise a mixture or combination of different a somatic cells, e.g., fibroblast, for example a mixture of cells such as a fibroblasts and other somatic cells.

[00154] In some embodiments, the population of a somatic cell, e.g., fibroblast is a substantially pure population of fibroblasts. In some embodiments, a population of a somatic cell, e.g., fibroblast is a population of somatic cells or differentiated cells. In some embodiments, the population of a somatic cell, e.g., fibroblast are substantially free or devoid of embryonic stem cells or pluripotent cells or iPS cells.

[00155] In some embodiments, a somatic cell, e.g., fibroblast is genetically modified. In some

embodiments, the somatic cell, e.g., fibroblast comprises one or more nucleic acid sequences encoding at the proteins of least three MN-inducing factors selected from Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl (encoded by genes of SEQ ID NO: 17-32 respectively) or functional variants or functional fragments thereof, as shown in Table 1.

[00156] Table 1. MN-inducing factors

inducing Acid acid factor

Lhx3 Homo sapiens NP_055379.1 NP_001034742.1 NM_014564 NM_001039653.1

LIM homeobox (SEQ ID NO: 1); (SEQ ID NO: 2) (SEQ ID NO: 17); (SEQ ID NO: 18)

3 (LHX3),

transcript

variant 2,

mRNA,

CPHD3; LIM3;

M2-LHX3

Ascll Homo sapiens NP_004307.2 NP_032579.2 NM_004316.3 NM_008553.4 achaete-scute (SEQ ID NO: 3) (SEQ ID NO: 4) (SEQ ID NO: 19); (SEQ ID NO:20) complex

homolog 1

(Drosophila)

(ASCL1),

ASH1 ;

bHLHa46;

HASH1 ;

MASH1

Brnl POU3F2, POU NP_005595.2 NP_032925.1 NM_005604.2 NM_008899.1 class 3 (SEQ ID NO: 5) (SEQ ID NO: 6) (SEQ ID NO: 21) (SEQ ID NO: 22) homeobox 2,

BRN2, OCT7,

POUF3

Mytll myelin NP_055840.2 NP_001087244.1 NM_015025.2 NM_001093775.1 transcription (SEQ ID NO: 7) (SEQ ID NO: 8) (SEQ ID NO: 23) (SEQ ID NO: 24) factor 1-like

(MYT1L),

KIAA1106,

"neural zinc

finger

transcription

factor 1 ", NZF1

Ml ISL LIM NP_002193.2 NP_067434.3 NM_002202.2 NM_021459.4 homeobox 1, (SEQ ID NO: 9) (SEQ ID NO: (SEQ ID NO: 25) (SEQ ID NO: 26)

Isl-1, ISLET 1 10) Hb9 motor neuron NP_001158727.1 NP_064328.2 NM_001165255.1 NM_019944.2 and pancreas (SEQ ID NO: (SEQ ID NO: (SEQ ID NO: 27) (SEQ ID NO: 28) homeobox 1, 11) 12)

MNX1, HB9,

HOXHB9,

SCRA1

Ngn2 Neurogenin 2 NP_076924.1 NP_033848.1 NM_024019.2 NM_009718.2

(NEUROG2), (SEQ ID NO: (SEQ ID NO: (SEQ ID NO: 29) (SEQ ID NO: 30)

Atoh4, 13) 14)

bHLHa8,

Math4A, ngn-2.

NeuroDl neurogenic NP 002491.2 NP_035024.1 NM_002500.3 NM_010894.2 differentiation (SEQ ID NO: (SEQ ID NO: (SEQ ID NO: 31) (SEQ ID NO: 32)

1 , beta-cell E- 15) 16)

box

transactivator

2", BETA2,

BHF-1,

bHLHa3,

MODY6,

NeuroD,

"neurogenic

helix-loop-helix

protein

NEUROD".

[00157] In some embodiments, a somatic cell, e.g., fibroblast can be isolated from a subject, for example as a tissue biopsy, such as, for example, a skin biopsy. In some embodiments, the a somatic cell, e.g., fibroblast are maintained in culture by methods known by one of ordinary skill in the art, and in some embodiments, propagated prior to being directly converted into iMNs by the methods as disclosed herein.

[00158] Further, a somatic cell, e.g., fibroblast can be from any mammalian species, with non-limiting

examples including a murine, bovine, simian, porcine, equine, ovine, or human cell. For clarity and simplicity, the description of the methods herein refers to a mammalian somatic cell, e.g., fibroblast, but it should be understood that all of the methods described herein can be readily applied to other cell types of somatic cells. In one embodiment, the somatic cell, e.g., fibroblast is derived from a human

individual, wherein the suitable MN-inducing factors are human (e.g., proteins of SEQ ID NO: 1, 3, 5, 7, 9, 11, 13 and 15 corresponding to human Lhx3, Ascll, Brn2, My til, Ml, Hb9, Ngn2 or NeuroDl polypeptides respectively). In alternative embodiments, the fibroblast is derived from a mouse subject, and wherein the suitable MN-inducing factors are mouse (e.g., proteins of SEQ ID NO: 2, 4, 6, 8, 10, 12, 14 and 16 corresponding to mouse Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides respectively). In some embodiments, mouse MN-inducing factors can be used to directly convert human fibroblasts to iMNs and vice versa, human MN-inducing factors can be used for transdifferentiation of mouse fibroblasts into iMNs. In some embodiments, any combination of mouse or human MN-inducing factors can be used for transdifferentiation of mouse or human fibroblasts into iMNs.

[00159] In some embodiments, at least three MN-inducing factors are used in the method for

transdifferentiation of a somatic cell, e.g., a fibroblast to a iMN according to the methods as disclosed herein. In some embodiments, at least 3, or a least 4, or a least 5, or a least 6, or a least 7, or a least 8, or a least 9, or a least 10, or a least 11 MN-inducing factors selected from any of the group consisting of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl are used in the methods of transdifferentiation of a somatic cell, e.g., a fibroblast to a iMN according to the methods as disclosed herein.

[00160] In some embodiments, Lhx3 and Ascll are used with any combination of other MN-inducing factor selected from the group of Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl. In some embodiments, Ascll, Lhx3 MN-inducing agents are used with Brn2, and Mytll in the methods to transdifferentiate a somatic cell, e.g., a fibroblast to a iMN. In some embodiments to increase efficiency of transdifferentiation, any one or more of a combination of the MN-inducing factors selected from isll, Hb9 and Ngn2 can also be used with Ascll, Lhx3, Brn2, and Mytll MN-inducing factors. In some embodiments, Mytll and/or Brn2 and/or isll are not used as MN-inducing factors in the methods as disclosed herein. Additionally, in some embodiments, miR-124 is not used as a MN-inducing agent. In some embodiments, for transdifferentiation of human somatic cells, e.g., human fibroblasts, NeuroDl is used as one of the MN- inducing agents.

[00161] In some embodiments, a subject from which a somatic cell, e.g., fibroblast are obtained is a

mammalian subject, such a human subject, and in some embodiments, the subject is suffering from a motor neuron disease, e.g., a amylotrophic lateral sclerosis (ALS), spinal muscular atrophy (SMA), primary lateral sclerosis (PLS), progressive bulbar palsy, pseudobulbar palsy, progressive muscular atrophy, post-polio syndrome (PPS) and the like. In such embodiments, the a somatic cell, e.g., fibroblast can be transdifferentiated into a iMNs ex vivo by the methods as described herein and then administered to the subject from which the cells were harvested in a method to treat the subject for the motor neuron disease or disorder.

[00162] In some embodiments, a somatic cell, e.g., fibroblast are located within a subject (in vivo) and are directly converted to become an iMN by the methods as disclosed herein in vivo. In some embodiments, direct conversion of a somatic cell., e.g., a fibroblast to a iMN in vivo can be achieved transducing the fibroblast with a viral vector, such as adenovirus which has the ability to express three or more MN- inducing agents selected from any combination of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl in the somatic cell.

[00163] In some embodiments, such contacting may be performed by maintaining the somatic cell, e.g., fibroblast in culture medium comprising the agent(s). In some embodiments a somatic cell, e.g., fibroblast can be genetically engineered. In some embodiments, a somatic cell, e.g., fibroblast can be genetically engineered to express one or more MN-inducing factors as disclosed herein, for example express at least one a polypeptide selected from Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl, or an amino acid sequences substantially homologous thereof, or functional fragments or functional variants thereof.

[00164] Where the somatic cell, e.g., fibroblast is maintained under in vitro conditions, conventional tissue culture conditions and methods can be used, and are known to those of skill in the art. Isolation and culture methods for various cells are well within the abilities of one skilled in the art.

[00165] In the methods of the present invention a somatic cell, e.g., fibroblast can, in general, be cultured under standard conditions of temperature, pH, and other environmental conditions, e.g., as adherent cells in tissue culture plates at 37°C in an atmosphere containing 5-10% C0₂. The cells and/or the culture medium are appropriately modified to achieve direct conversion to iMNs as described herein. In certain embodiments, a somatic cell, e.g., fibroblast can be cultured on or in the presence of a material that mimics one or more features of the extracellular matrix or comprises one or more extracellular matrix or basement membrane components. In some embodiments Matrigel™ is used. Other materials include proteins or mixtures thereof such as gelatin, collagen, fibronectin, etc. In certain embodiments of the invention, a somatic cell, e.g., fibroblast can be cultured in the presence of a feeder layer of cells. Such cells may, for example, be of murine or human origin. They can also be irradiated, chemically inactivated by treatment with a chemical inactivator such as mitomycin c, or otherwise treated to inhibit their proliferation if desired. In other embodiments a somatic cell, e.g., fibroblast are cultured without feeder cells.

Methods of transdifferentiation of somatic cells to iMNs

[00166] Generating iMN by direct conversion of a somatic cell, e.g., fibroblast using the methods of the present invention has a number of advantages. First, the methods of the present invention allow one to generate autologous iMNs, which are cells specific to and genetically matched with an individual. The cells are derived from a somatic cell, e.g., fibroblast obtained from the individual. In general, autologous cells are less likely than non-autologous cells to be subject to immunological rejection.

[00167] Second, the methods of the present invention allow the artisan to generate iMNs without using embryos, oocytes, and/or nuclear transfer technology. Herein, the applicants' results demonstrate that a somatic cell, e.g., fibroblast can be directly converted to become a motor neuron (iMN), without the need to be fully reprogrammed to a pluripotent state, therefore minimizing the risk of differentiation into unwanted cell types or risk of teratomas formation.

[00168] Also encompassed in the methods of the present invention is a method of transdifferentiation of a somatic cell, e.g., fibroblast by means other than engineering the cells to express MN-inducing factors, i.e., by contacting the a somatic cell, e.g., fibroblast with a MN-inducing factors other than a nucleic acid or viral vector capable of being taken up and causing a stable genetic modification to the cells. In particular, the invention encompasses the recognition that extracellular signaling molecules, e.g., molecules that when present extracellularly bind to cell surface receptors and activate intracellular signal transduction cascades, are of use to reprogram somatic cells. The invention further encompasses the recognition that activation of such signaling pathways by means other than the application of extracellular signaling molecules is also of use to directly convert a somatic cell, e.g., fibroblast into a iMN. In addition, the methods of the present invention relate to methods of identification of the iMNs that are detectable based on morphological criteria, without the need to employ a selectable marker, as well as functional characteristics, such as ability to generate action potentials, resting membrane potential of less than -50mV, responsive to inhibitory neurotransmitters such as glycine and GAB A, and responsiveness to excitatory neurotransmitters such as glutamate. The present disclosure thus reflects several fundamentally important advances in the area of somatic cell transdifferentiation technology, in particular direct conversion of somatic cells to a subtype of neurons, in particular, motor neurons.

[00169] While certain aspects of the invention are exemplified herein using at least three of eleven

different MN-inducing factors, e.g., Lhx3 (SEQ ID NO: 1-2), Ascll (SEQ ID NO: 3-4), Brn2 (SEQ ID NO: 5-6), Mytll (SEQ ID NO: 7-8), Ml (SEQ ID NO: 9-10), Hb9 (SEQ ID NO: 11-12), Ngn2 (SEQ ID NO: 13-14) NeuroDl (SEQ ID NO: 15-16), the methods of the invention encompass use of any other MN-inducing factors in replace of any one of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl, where the other MN-inducing factors includes, for example, but is not limited to, Oligo2, Pax6, Soxl, Nkx6.1 or functional variants, homologues or functional fragments thereof for the purposes of converting a somatic cell, e.g., fibroblast to iMN.

[00170] Another aspect of the present invention relates to methods to produce a population of isolated iMN by increasing the protein expression of at least three MN-inducing factors in a population of a somatic cell, e.g., fibroblast. In some embodiments, a somatic cell, e.g., fibroblast can be treated in any of a variety of ways to cause direct conversion of the fibroblast to an iMN according to the methods of the present invention. For example, in some embodiments, the treatment can comprise contacting the cells with one or more agent(s), herein referred to as a "MN-inducing factor" which increases the protein expression of at least three of the transcription factors selected from Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl,, or increases the protein expression of a functional homologue or a functional fragment of at least three of any combination of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl, polypeptides in the somatic cell, e.g., fibroblast. [00171] In some embodiments, the method comprises converting a somatic cell, e.g., fibroblast by increasing the protein expression of at least three in any combination of the following MN-inducing factors Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl, in the somatic cell, e.g., fibroblast, wherein the expression is for sufficient amount of time, typically transient increase in expression, to allow the conversion of the cell to become a cell which exhibits at least two characteristics of a endogenous motor neuron (e.g., a motor neuron differentiated from an embryonic stem cell), for example at least two of the following characteristics; (i) expression of motor neuron markers, for example, but not limited to P2-tubulins (e.g, Tubb2a and Tubb2b), Map2, synapsins (e.g., Synl and Syn2), synaptophysin, synaptotagmins (e.g., Sytl, Syt4, Sytl3, Syt 16), NeuroD, Ml,

cholineacetyltransierase (ChAT), e.g., vescular ChAT, (ii) significantly decreased level of expression of fibroblast genes from which they are derived, selected from the group of: Snaill, thyl and Fspl, (iii) exhibit typical motor neuron morphology, e.g., comprising a cell body with axonal projections which form functional synaptic junctions with muscle cells and (iv) an average resting potential of lower than about -50mV, e.g., a resting potential of about -50mV to about -65mV and any interger between, e.g., about -50mV, or about -50 to -55mV or about -55mV to about -60mV or about -60mV to about -65mV, or alternatively a resting potential substantially the same as the resting membrane potential of motor neurons differentiated from embryonic stem cells (v) functional motor neuron characteristics selected from (a) the ability to fire action potentials, (b) responsiveness to inhibitory neurotransmitters glycine and GAB A, and (c) responsiveness to excitatory neurotransmitters, e.g., glutamate or kainate.

[00172] In some embodiments, the method comprises reprogramming a somatic cell, e.g., fibroblast by increasing the protein expression of three or more of following MN-inducing transcription factors Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl in the somatic cell, e.g., fibroblast. The increase in expression of the transcription factors can be done all at the same time (e.g. concurrently), or alternatively, subsequently in any order.

[00173] In some embodiments, the method comprises reprogramming a somatic cell, e.g., fibroblast by expressing at least 2, or at least 3, or at least 4 or at least 5, or at least 6, or at least 7 or at least 8, or at least 9 or at least 10 or 11 of any combination of MN-inducing factors selected from, for example, but is not limited to, Lhx3 (SEQ ID NO: 1-2), Ascll (SEQ ID NO: 3-4), Brn2 (SEQ ID NO: 5-6), Mytll (SEQ ID NO: 7-8), Ml (SEQ ID NO: 9-10), Hb9 (SEQ ID NO: 11-12), Ngn2 (SEQ ID NO: 13-14) NeuroDl (SEQ ID NO: 15-16) or functional variants, polypeptides with amino acids substantially homologues or functional fragments thereof in a somatic cell, e.g., fibroblast to reprogram to an iMN.

[00174] In some embodiments, increasing the protein expression can be by any means known by one of ordinary art, for example can include introduction of nucleic acid, or nucleic acid analogue encoding one or more of the MN-inducing factors, or contacting the somatic cell, e.g., fibroblast with an agent which converts the somatic cell, e.g., fibroblast to a cell with a motor neuron phenotype. In some embodiments, a nucleic acid analogue is a locked nucleic acid (LNA), or a modified synthetic RNA (modRNA) encoding one or more of the MN-inducing factors. ModRNA are well known by one of ordinary skill in the art, and are are described in U.S. Provisional Application 61/387,220, filed September 28, 2010, and U.S. Provisional Application 61/325,003, filed: April 16, 2010, both of which are incorporated herein in their entirety by reference.

[00175] In some embodiments, a MN-inducing agent is a vector comprising a nucleotide sequence

encoding the polypeptide one or more of Lhx3 (SEQ ID NO: 1-2), Ascll (SEQ ID NO: 3-4), Brn2 (SEQ ID NO: 5-6), Mytll (SEQ ID NO: 7-8), Ml (SEQ ID NO: 9-10), Hb9 (SEQ ID NO: 11-12), Ngn2 (SEQ ID NO: 13-14) NeuroD (SEQ ID NO: 15-16) or encoding a polypeptide substantially homologous to SEQ ID NO: 1-16 or a functional variant or functional fragment of polypeptides of sequences SEQ ID NO: l -16. In such embodiments, the nucleotide sequence can comprise any nucleic acid sequence selected from SEQ ID NO: 17-32 respectively, or a fragment or variant thereof.

[00176] In some embodiments, the vector is a viral vector. In some embodiments, the viral vector is a non- integrating viral vector. While retroviral vectors incorporate into the host cell genome and can potentially disrupt normal gene function, non-integrating vectors have the advantage of controlling expression of a gene product by extra-chromosomal transcription. It follows that since non-integrating vectors do not become part of the host genome, non-integrating vectors tend to express a nucleic acid transiently in a cell population. This is due in part to the fact that the non-integrating vectors as used herein are rendered replication deficient. Thus, non-integrating vectors have several advantages over retroviral vectors including but not limited to: (1) no disruption of the host genome, and (2) transient expression, and (3) no remaining viral integration products.

[00177] Some non-limiting examples of non-integrating vectors include adenovirus, baculovirus,

alphavirus, picornavirus, and vaccinia virus. In one embodiment, the non-integrating viral vector is an adenovirus. The advantages of non-integrating viral vectors further include the ability to produce them in high titers, their stability in vivo, and their efficient infection of host cells.

[00178] While it is known that some non-integrating vectors integrate into the host genome at extremely low frequencies (i.e., 10^"4 to 10^"5), a non-integrating vector, as the term is used herein, refers to vectors having a frequency of integration of less than 0.1% of the total number of infected cells; preferably the frequency of integration is less than 0.01%, less than 0.001%, less than 0.0001%, or less than

0.000001% (or lower) of the total number of infected cells. In one embodiment, the vector does not integrate at all. In another embodiment, the viral integration remnants of the virus are below the detection threshold as assayed by PCR (for nucleic acid detection) or immunoassay (for protein detection). In general, iMNs produced by the methods described herein should be assayed for an integration event by the viral vector using, for example, PCR-mediated detection of the viral genome prior to administering a population of iMNs to a subject. Any iMN with detectable integration products should not be administered to a subject.

[00179] The viral titer necessary to achieve a desired (i.e., effective) level of gene expression in a host cell is dependent on many factors, including, for example, the cell type, gene product, culture conditions, co- infection with other viral vectors, and co-treatment with other agents, among others. It is well within the abilities of one skilled in the art to test a range of titers for each virus or combination of viruses by detecting the expression levels of either (a) a marker expression product, or (b) a test gene product. Detection of protein expression in cells can be achieved by several techniques including Western blot analysis, immuno-cytochemistry, and fluorescence-mediated detection, among others. It is contemplated that experiments are first optimized by testing a variety of titer ranges for each cell type under the desired culture conditions. Once an optimal titer of a virus or a cocktail of viruses is determined, then that protocol will be used to induce the reprogramming of somatic cells.

[00180] In addition to viral titers, it is also important that the infection and induction times are appropriate with respect to different cells. For example, as discussed in the Examples section herein, initial attempts with an adenoviral vector were deemed unsuccessful due to an inadequate induction time. Upon recognition of this important consideration and considerable lengthening of induction time, induced pluripotent stem cells were produced using an adenoviral vector. With the knowledge provided herein that length of time is an important variable in induced pluripotent stem cell induction, one of skill in the art can test a variety of time points for infection or induction using a non-integrating vector and recover induced pluripotent stem cells from a given somatic cell type.

[00181] In some embodiments, the vector is a non-viral polycystronic vector as disclosed in Gonzalez et al., Proc. Natl. Acad. Sci. USA 2009 106:8918-8922; Carey et al., PNAS, 2009; 106;157-162,

WO/2009/065618 and WO/2000/071096 and Okita et al., Science 7, 2008: 322; 949 - 953, which are all incorporated herein in their entirety by reference.

[00182] In some embodiments, the nucleic acid is a modified synthetic RNA (modRNA) encoding one or more of the MN-inducing factors. ModRNA are well known by one of ordinary skill in the art, and are are described in U.S. Provisional Application 61/387,220, filed September 28, 2010, and U.S.

Provisional Application 61/325,003, filed: April 16, 2010, both of which are incorporated herein in their entirety by reference.

[00183] In other embodiments, the methods or the present invention encompass non-viral means to

increase the expression of iMN inducing factors (e.g. Lhx3 (SEQ ID NO: 1-2), Ascll (SEQ ID NO: 3-4), Brn2 (SEQ ID NO: 5-6), Mytll (SEQ ID NO: 7-8), Ml (SEQ ID NO: 9-10), Hb9 (SEQ ID NO: 11-12), Ngn2 (SEQ ID NO: 13-14) NeuroDl (SEQ ID NO: 15-16) in a somatic cell, e.g., fibroblast for the purposes for converting to an iMN as disclosed herein. For example, in one embodiment, naked DNA technology can be used, for example nucleic acid encoding the polypeptides of least three transcription factors selected from Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl (encoded by SEQ ID NO: 17-32 respectively) can be introduced into a somatic cell, e.g., fibroblast for the purposes of converting the cell to an iMN. Methods of naked DNA technology are well known in the art, and are disclosed in U.S Patent 6,265,387 (which is incorporated herein in its entirety by reference) which describes a method of delivering naked DNA into a hepatocyte in vivo the via bile duct. U.S. Patent 6,372,722 (which is incorporated herein in its entirety by reference) describes a method of naked DNA delivery to a secretory gland cell, for example, a pancreatic cell, a mammary gland cell, a thyroid cell, a thymus cell, a pituitary gland cell, and a liver cell.

[00184] In some embodiments, another non-viral means to increase the expression of the transcription factors (e.g. Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl,) in a somatic cell, e.g., fibroblast include use of piggyBac transposon vectors, as disclosed in U.S. Patents 7,129,083, and 6,5518,25; U.S. Patent Application 2009/0042297 and International Patent Application WO/2007/100821 which are incorporated herein in their entirety by reference.

[00185] Other non-viral means to increase the expression of the transcription factors (e.g. Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl,) in a somatic cell, e.g., fibroblast for the purposes for transdifferentiation to a iMN are also encompassed for use in the methods as disclosed herein.

[00186] In one embodiment, one can contact the a somatic cell, e.g., fibroblast with polypeptides or

peptides of Lhx3 (SEQ ID NO: 1-2), Ascll (SEQ ID NO: 3-4), Brn2 (SEQ ID NO: 5-6), Mytll (SEQ ID NO: 7-8), Isll (SEQ ID NO: 9-10), Hb9 (SEQ ID NO: 11-12), Ngn2 (SEQ ID NO: 13-14) NeuroDl (SEQ ID NO: 15-16) or functional variants, polypeptides with amino acids substantially homologues or functional fragments thereof in a somatic cell, e.g., fibroblast to convert to an iMN. Alternatively, one can use aptamers or antibodies or any other agent which activates and increases the expression of the transcription factors (e.g. Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl) in a somatic cell, e.g., fibroblast.

[00187] In alternative embodiments, one can contact the somatic cell, e.g., fibroblast with a small molecule or combination of small molecules (e.g. chemical complementation) to increase the expression of at least two transcription factors in the somatic cell, e.g., fibroblast.

[00188] Thus, in some embodiments, the contacting step will typically be for at least twenty-four hours. By "at least twenty-four hours," is meant twenty-four hours or greater. In some embodiments, fibroblast cells can be contacted with MN-inducing factor (e.g. small molecule, polypeptide, nucleic acid, nucleic acid analogues, etc) for about 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60 hours up to 3, 4, 5, 6, 7, or more days or any particular intervening time in hours or minutes within the above range. Preferably, somatic cells, e.g., fibroblasts can be contacted with a MN-inducing agent for seven days.

[00189] In another embodiment, the present invention provides a method of direct conversion of somatic cells, e.g., fibroblasts by contacting the somatic cell with at least 3 or more polypeptides selected from any combination from the group of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl, or having amino acid sequences substantially homologous thereto, and functional fragments or functional variants thereof. In some embodiments, the present invention provides a method of reprogramming a somatic cell, e.g., fibroblast comprising contacting the somatic cell, e.g., fibroblast with at least 3 polypeptides selected from the group of polypeptides of SEQ ID NO: 1-16, or having amino acid sequences substantially homologous thereto, and functional fragments or functional variants thereof. [00190] Where the MN-inducing factor is a polypeptide, e.g. a polypeptide of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl, the dosages of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides, their active fragments or related growth factors to be used in the in vivo or in vitro methods and processes of the invention preferably range from about 1 pmoles/kg/minute to about 100 nmoles/kg/minute for continuous administration and from about 1 nmoles/kg to about 40 mmoles/kg for bolus injection. Preferably, the dosage of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroD polypeptides in in vitro methods will be 10 pmoles/kg/min to about 100 nmoles/kg/min, and in in vivo methods from about 0.003 nmoles/kg/min to about 48 nmoles/kg/min. More preferably, the dosage of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides in in vitro methods ranges from about 100 picomoles/kg/minute to about 10 nanomoles/kg/minute, and in in vivo methods from about 0.03 nanomoles/kg/minute to about 4.8 nanomoles/kg/minute. In some embodiments, the preferred dosage of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides, or other polypeptides of sequences SEQ ID NO: 1-16 in in vitro methods is 1 pmoles/kg/min to about 10 nmoles/kg/mine, and in in vivo from about 1 pmole/kg to about 400 pmoles/kg for a bolus injection. The more preferred dosage of the preferred dosage of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl polypeptides, or other polypeptides of sequences SEQ ID NO: 1-16 in in vitro methods ranges from about 10 pmole/kg/minute to about 1 nmole/kg/minute, and in in vivo from about 10 pmoles/kg to about 40 pmoles/kg for a bolus injection.

Confirming presence of a iMN

[00191] An iMN as disclosed herein, produced by the methods as disclosed herein is a cell with the

phenotypic characteristics of an endogenous motor neurons. An iMN can have all the phenotypic and functional characteristics of an endogenous motor neuron or may have less than all the phenotypic and functional characteristics of an endogenous motor neuron.

[00192] In some embodiments, the iMN can exhibit a motor neuron morphology but otherwise maintain at least one phenotypic characteristic of the somatic cell from which it as converted from. For example, in some embodiments, a somatic cell, e.g., fibroblast that is subjected to an increase in at least three MN- inducing factors as disclosed herein can continue to express Snail and other fibroblast markers, but, unlike the typical fibroblast, the iMN cell also conducts action potentials and exhibits one or more functional characteristics of a motor neuron. Thus, a continuum between complete phenotypic change and a single phenotypic change is possible. An increase in proliferation of a somatic cell, e.g., fibroblast may precede the direct conversion to iMNs, and "transdifferentiation" is not meant to exclude any proliferation that accompanies the change of the cell to a iMN phenotype.

[00193] To confirm the transdifferentiation of a somatic cell, e.g., fibroblast to an iMN, isolated clones can be tested for the expression of a marker of motor neurons. Such expression identifies the cells as motor neuron. Markers for motor neurons (iMNs) can be selected from the non-limiting group including β2- tubulins (e.g, Tubb2a and Tubb2b), Map2, synapsins (e.g., Synl and Syn2), synaptophysin, synaptotagmins (e.g., Sytl, Syt4, Sytl3, Syt 16), NeuroD, Isll, cholineacetyltransferase (ChAT), e.g., vescular ChAT (VChAT), immunostaining of a-BTX, where expression is by a statistically significant amount as compared to the somatic cell, e.g., fibroblast from which the iMN was converted from.

[00194] Methods for detecting the expression of such markers are well known in the art, and include, for example, RT-PCR and immunological methods that detect the presence of the encoded polypeptides, such as ELISA.

[00195] In some embodiments, an iMNs produced by the methods as disclosed herein can be identified based on unique morphological characteristics. In some embodiments, the iMN have a large cell body and axonal projections which form synaptic connections with muscle. As disclosed herein, iMN can be co-cultured with muscle cells, e.g., myotubules or C2C12 muscle co-culture according to the methods disclosed in the Examples section and form axonal projections alonh the length of the myotubules, which undergo regular and rhythmic contractions due to the synaptic connections with the iMNs (see Fig. 41). Thus, in some embodiments, the iMN have a unique functional characteristics with muscle as compared to other non-motor neuron neuronal subtypes.

[00196] In some embodiments, the iMN can be identified based on an average resting potential of lower than about -50mV, e.g., a resting potential of about -50mV to about -65mV and any integer between, e.g., about -50mV, or about -50 to -55mV or about -55mV to about -60mV or about -60mV to about - 65mV, or alternatively a resting potential substantially the same as the resting membrane potential of motor neurons differentiated from embryonic stem cells. In some embodiments, a iMN can be identified based on functional motor neuron characteristics, such as, but not limited to (a) the ability to fire action potentials, (b) responsiveness to inhibitory neurotransmitters glycine and GAB A, and (c) responsiveness to excitatory neurotransmitters, e.g., glutamate or kainate.

[00197] In some embodiments, the iMN has a cell body size between about 30-80μπι in diameter, for example, in some embodiments, the iMN are gamma MN and are about at least about 40μπι, or at least about 50μπι, or about at least 60μπι, or at least about 70μπι, or at least about 80μπι, or any integer between about 40-80μπι, and in some embodiments, the iMN is an alpha motor neuron, and has a cell body size of at least about 19μπι, or at least about 20μπι, or at least about 21μπι, or at least about 22μπι, or at least about 23μπι, or at least about 24μπι, or at least about 25μπι, or at least about 26μπι, or at least about 27μπι, or greater than about 30μπι in diameter, or any integer between about 15-35μπι in diameter.

[00198] In some embodiments, the present invention relates to an isolated population of iMN produced by the methods as disclosed herein. In some embodiments, iMN can be isolated by methods known in the art, for example FACs sorting, as disclosed in Liu et al , Journal Sichuan University, medical science edition, 209; 40(1); 153-6 or Liu et al, J Biol Chem, 1998; 273, 22201-22208, which are incorporated herein by reference).

Monitoring the Production of iMNs from a somatic cell, e.g., fibroblast [00199] The progression of a somatic cell, e.g., fibroblast to an iMN can be monitored by determining the expression of markers characteristic of motor neurons. In some processes, the expression of certain markers is determined by detecting the presence or absence of the marker. Alternatively, the expression of certain markers can be determined by measuring the level at which the marker is present in the cells of the cell culture or cell population. In certain processes, the expression of markers characteristic of motor neurons as well as the lack of significant expression of markers characteristic of the somatic cell, e.g., fibroblast from which it was derived can readily be determined.

[00200] As described in connection with monitoring the production of an iMN, qualitative or semiquantitative techniques, such as blot transfer methods and immunocytochemistry, can be used to measure marker expression. Alternatively, marker expression can be accurately quantitated through the use of technique such as Q-PCR. Additionally, it will be appreciated that many of the markers of iMNs are secreted compounds such as acetly choline. As such, techniques for measuring extracellular motor neuron marker content include HPLC or ELISA or other methods commonly known by persons of ordinary skill in the art.

[00201] As set forth in the Examples below, markers of motor neurons include the expression of markers, but are not limited to, 2-tubulins (e.g, Tubb2a and Tubb2b), Map2, synapsins (e.g., Synl and Syn2), synaptophysin, synaptotagmins (e.g., Sytl, Syt4, Sytl3, Syt 16), NeuroD, Ml, cholineacetyltransferase (ChAT), e.g., vascular ChAT (VChAT), immunostaining of OC-BTX.

[00202] The iMNs produced by the processes described herein express one or more of the above-listed markers, thereby producing the corresponding gene products. However, it will be appreciated that iMNs need not express all of the above-described markers. For example, iMNs converted from a somatic cell, e.g., fibroblast do not always express Ml.

[00203] In some embodiments, the transition of a somatic cell, e.g., fibroblast to an iMN can be validated by monitoring the decrease in expression of fibroblast markers, e.g., Snail, Thyl and Fspl while monitoring the increase in expression of one or more of motor neuron markers. In addition to monitor the increase and/or decrease in expression of one or more the above-described markers, in some processes, the expression of genes indicative motor neurons or other neuronal markers can also be monitored.

[00204] It will be appreciated that 2-tubulins (e.g, Tubb2a and Tubb2b), Map2, synapsins (e.g., Synl and Syn2), synaptophysin, synaptotagmins (e.g., Sytl, Syt4, Sytl 3, Syt 16), NeuroD, Ml,

cholineacetyltransferase (ChAT), e.g., vescular ChAT (VChAT) marker expression is induced over a range of different levels in iMN depending on the differentiation conditions. As such, in some embodiments described herein, the expression of these markers are similar to the levels of expression in motor neurons differentiated from embryonic stem cells, e.g., at least about 70%, or at least about 80% or at least about 90% or at least about 100% or more than 100% the level of the expression of these markers by ES-derived motor neurons (see Fig 9B-9F in the Examples section). Methods of identifying agents for transdifferentiation of somatic cells to iMNs.

[00205] Another aspect of the present invention relates to methods of identifying agents that alone or in combination with other agents convert a somatic cell, e.g., fibroblast to an iMN. In some embodiments, the method includes contacting one or more a somatic cell, e.g., fibroblast with one or more test agents (simultaneously or at separate times) and determining the level of expression of one or more MN- inducing factors as defined herein. In some embodiments, the MN-inducing factors include any one of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl. Where one or more test agents increase the level of expression of one or more of the foregoing genes above the level of expression normally found in the somatic cell, in the absence of one or more test agents, are considered candidate agents to be used as an MN-inducing agents for transdifferentiation of a somatic cell, e.g., fibroblast to an iMN. The test agents may include, but are not limited to, small molecules, nucleic acids, peptides, polypeptides,

immunoglobulins, and oligosaccarides. In some embodiments, the just-mentioned method includes determining the level of expression of one or more of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl, and preferably, in some embodiments, a single agent which increase one or more (e.g., 2, 3, 4, or 5 or more than 5) of the genes selected from Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl. In some embodiments, the method includes determining the level of expression of one or more of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl. Expression levels can be determined by any means known by one of ordinary skill in the art, for example, by RT-PCR or immunological methods.

[00206] Of particular interest are screening assays for agents that are active transdifferentiation human a somatic cell, e.g., fibroblast to a iMN. A wide variety of assays may be used for this purpose, including immunoassays for protein binding; determination of cell growth, differentiation and functional activity; production of factors; and the like.

[00207] In the screening method of the invention for agents, the a somatic cell, e.g., fibroblast are

contacted with the agent of interest, and the effect of the agent assessed by monitoring output parameters, such as expression of MN-inducing factors such as, but not limited to Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl, cell viability, motor neuron functional characteristics, and the like. The cells may be freshly isolated, cultured, genetically engineered as described above, or the like. The somatic cell, e.g., fibroblast may be environmentally induced variants of clonal cultures: e.g. split into independent cultures and grown under distinct conditions, for example with or without virus; in the presence or absence of other cytokines or combinations thereof. Alternatively, a somatic cell, e.g., fibroblast may be variants with a desired pathological characteristic. For example, the desired pathological characteristic includes a mutation and/or polymorphism which contribute to disease pathology.

[00208] In alternative embodiments, the methods of the invention can be used to screen for agents in which a somatic cell, e.g., fibroblast comprising a particular mutation and/or polymorphism respond differently compared with a somatic cell, e.g., fibroblast without the mutation and/or polymorphism, therefore the methods can be used for example, to asses an effect of a particular drug and/or agent on iMNs from a defined subpopulation of people and/or cells, therefore acting as a high-throughput screen for personalized medicine and/or pharmogenetics. The manner in which cells respond to an agent, particularly a pharmacologic agent, including the timing of responses, is an important reflection of the physiologic state of the cell. Accordingly, the iMNs generated from human fibroblasts can be useful to study disease mechanisms due to different mutations for ALS and SMA, as well as to identify agents or therapeutic treatment to treat motor neuron diseases of different genetic ALS and SMA phenotypes, as well iMNs from subjects where the complex genetic variation resulting in the motor neuron disease is not yet known.

[00209] The agent used in the screening method can be selected from a group of a chemical, small

molecule, chemical entity, nucleic acid sequences, an action; nucleic acid analogues or protein or polypeptide or analogue of fragment thereof. In some embodiments, the nucleic acid is DNA or RNA, and nucleic acid analogues, for example can be PNA, pcPNA and LNA. A nucleic acid may be single or double stranded, and can be selected from a group comprising; nucleic acid encoding a protein of interest, oligonucleotides, PNA, etc. Such nucleic acid sequences include, for example, but not limited to, nucleic acid sequence encoding proteins that act as transcriptional repressors, antisense molecules, ribozymes, small inhibitory nucleic acid sequences, for example but not limited to RNAi, shRNAi, siRNA, micro RNAi (mRNAi), antisense oligonucleotides etc. A protein and/or peptide agent or fragment thereof, can be any protein of interest, for example, but not limited to; mutated proteins;

therapeutic proteins; truncated proteins, wherein the protein is normally absent or expressed at lower levels in the cell. Proteins of interest can be selected from a group comprising; mutated proteins, genetically engineered proteins, peptides, synthetic peptides, recombinant proteins, chimeric proteins, antibodies, humanized proteins, humanized antibodies, chimeric antibodies, modified proteins and fragments thereof. The agent may be applied to the media, where it contacts the cell (such as a somatic cell, e.g., fibroblast) and induces its effects. Alternatively, the agent may be intracellular within the cell (e.g. a somatic cell, e.g., fibroblast) as a result of introduction of the nucleic acid sequence into the cell and its transcription resulting in the production of the nucleic acid and/or protein agent within the cell. An agent also encompasses any action and/or event the cells (e.g. a somatic cell, e.g., fibroblast) are subjected to. As a non-limiting examples, an action can comprise any action that triggers a physiological change in the cell, for example but not limited to; heat-shock, ionizing irradiation, cold-shock, electrical impulse, light and/or wavelength exposure, UV exposure, pressure, stretching action, increased and/or decreased oxygen exposure, exposure to reactive oxygen species (ROS), ischemic conditions, fluorescence exposure etc. Environmental stimuli also include intrinsic environmental stimuli defined below. The exposure to agent may be continuous or non-continuous.

[00210] In some embodiments, the agent is an agent of interest including known and unknown compounds that encompass numerous chemical classes, primarily organic molecules, which may include organometallic molecules, inorganic molecules, genetic sequences, etc. An important aspect of the invention is to evaluate candidate drugs, including toxicity testing; and the like. Candidate agents also include organic molecules comprising functional groups necessary for structural interactions, particularly hydrogen bonding, and typically include at least an amine, carbonyl, hydroxyl or carboxyl group, frequently at least two of the functional chemical groups. The candidate agents often comprise cyclical carbon or heterocyclic structures and/or aromatic or polyaromatic structures substituted with one or more of the above functional groups. Candidate agents are also found among biomolecules, including peptides, polynucleotides, saccharides, fatty acids, steroids, purines, pyrimidines, derivatives, structural analogs or combinations thereof.

[00211] Also included as agents are pharmacologically active drugs, genetically active molecules, etc.

Compounds of interest include, for example, chemotherapeutic agents, hormones or hormone antagonists, growth factors or recombinant growth factors and fragments and variants thereof.

Exemplary of pharmaceutical agents suitable for this invention are those described in, "The

Pharmacological Basis of Therapeutics," Goodman and Oilman, McGraw-Hill, New York, N.Y., (1996), Ninth edition, under the sections: Water, Salts and Ions; Drugs Affecting Renal Function and Electrolyte Metabolism; Drugs Affecting Gastrointestinal Function; Chemotherapy of Microbial Diseases;

Chemotherapy of Neoplastic Diseases; Drugs Acting on Blood-Forming organs; Hormones and

Hormone Antagonists; Vitamins, Dermatology; and Toxicology, all incorporated herein by reference. Also included are toxins, and biological and chemical warfare agents, for example see Somani, S. M. (Ed.), "Chemical Warfare Agents," Academic Press, New York, 1992).

[00212] The agents include all of the classes of molecules described above, and may further comprise samples of unknown content. Of interest are complex mixtures of naturally occurring compounds derived from natural sources such as plants. While many samples will comprise compounds in solution, solid samples that can be dissolved in a suitable solvent may also be assayed. Samples of interest include environmental samples, e.g. ground water, sea water, mining waste, etc.; biological samples, e.g. lysates prepared from crops, tissue samples, etc.; manufacturing samples, e.g. time course during preparation of pharmaceuticals; as well as libraries of compounds prepared for analysis; and the like. Samples of interest include compounds being assessed for potential therapeutic value, i.e. drug candidates.

[00213] Parameters are quantifiable components of a somatic cell, e.g., fibroblast, particularly the

expression of genes (e.g., protein expression or mRNA expression) such as, one or more in any combination of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl. In some embodiments, expression of one or more, in any combination of Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl that can be accurately measured, desirably in a high throughput system. In some embodiments, a high throughput screen for resting membrane potential and responsiveness to inhibitory neurotransmitters, such as GABA and glycine, and excitatory neurotransmitters, such as glutamate can be used to identify an agent which induces transdifferentiation of a fibroblast into a functional iMN. In some embodiments, a secondary screen can be used to assess the functional characteristics if the iMN, e.g., ability to form synaptic junctions with mucle cells, as well as expression of motor neuron markers, for example, but not limited to, expression of 2-tubulins (e.g, Tubb2a and Tubb2b), Map2, synapsins (e.g., Synl and Syn2), synaptophysin, synaptotagmins (e.g., Sytl, Syt4, Sytl3, Syt 16), NeuroD, Isll, cholineacetyltransferase (ChAT), e.g., vescular ChAT (VChAT), immunostaining of OC-BTX. In some embodiments, the iMNs may express transcription factors specifically expressed in motor neurons, including Lim3, and HoxBl , HoxB6, HoxC5 and HoxC8, but not other neuronal markers of non-motor neuron subtypes. For instance, iMNs can be identified by lack of expression of forebrain neuronal markers, Otx2 and Bf-1, or mid-brain markers, En-1.

[00214] In some embodiments, an output parameter from the screen can be any cell component or cell product including cell surface determinant, receptor, protein or conformational or posttranslational modification thereof, lipid, carbohydrate, organic or inorganic molecule, nucleic acid, e.g. mRNA, DNA, etc. or a portion derived from such a cell component or combinations thereof. While most parameters will provide a quantitative readout, in some instances a semi-quantitative or qualitative result will be acceptable. Readouts may include a single determined value, or may include mean, median value or the variance, etc. Characteristically a range of parameter readout values will be obtained for each parameter from a multiplicity of the same assays. Variability is expected and a range of values for each of the set of test parameters will be obtained using standard statistical methods with a common statistical method used to provide single values. In some embodiments, the assay is a computerized assay or a robotic high-throughput system operated through a computer interface.

[00215] Compounds, including candidate agents, are obtained from a wide variety of sources including libraries of synthetic or natural compounds. For example, numerous means are available for random and directed synthesis of a wide variety of organic compounds, including biomolecules, including expression of randomized oligonucleotides and oligopeptides. Alternatively, libraries of natural compounds in the form of bacterial, fungal, plant and animal extracts are available or readily produced. Additionally, natural or synthetically produced libraries and compounds are readily modified through conventional chemical, physical and biochemical means, and may be used to produce combinatorial libraries. Known pharmacological agents may be subjected to directed or random chemical modifications, such as acylation, alkylation, esterification, amidification, etc. to produce structural analogs.

[00216] Agents are screened for effect on a somatic cell, e.g., fibroblast by adding the agent to at least one and usually a plurality of a somatic cell, e.g., a population of fibroblasts, and can be performed concurrently with a test well with a somatic cell, e.g., fibroblast lacking the agent (e.g., reference culture). The change in parameters in response to the agent is measured, and the result evaluated by comparison to reference cultures, e.g. in the presence and absence of the agent, obtained with other agents, etc.

[00217] The agents are conveniently added in solution, or readily soluble form, to the medium of cells in culture. The agents may be added in a flow-through system, as a stream, intermittent or continuous, or alternatively, adding a bolus of the compound, singly or incrementally, to an otherwise static solution. In a flow-through system, two fluids are used, where one is a physiologically neutral solution, and the other is the same solution with the test compound added. The first fluid is passed over the cells, followed by the second. In a single solution method, a bolus of the test compound is added to the volume of medium surrounding the cells. The overall concentrations of the components of the culture medium should not change significantly with the addition of the bolus, or between the two solutions in a flow through method. In some embodiments, agent formulations do not include additional components, such as preservatives, that may have a significant effect on the overall formulation. Thus preferred formulations consist essentially of a biologically active compound and a physiologically acceptable carrier, e.g. water, ethanol, DMSO, etc. However, if a compound is liquid without a solvent, the formulation may consist essentially of the compound itself.

[00218] A plurality of assays may be run in parallel with different agent concentrations to obtain a

differential response to the various concentrations. As known in the art, determining the effective concentration of an agent typically uses a range of concentrations resulting from 1 : 10, or other log scale, dilutions. The concentrations may be further refined with a second series of dilutions, if necessary. Typically, one of these concentrations serves as a negative control, i.e. at zero concentration or below the level of detection of the agent or at or below the concentration of agent that does not give a detectable change in the phenotype.

[00219] Optionally, a somatic cell, e.g., fibroblast used in the screen can be manipulated to express desired gene products. Gene therapy can be used to either modify a cell to replace a gene product or add or knockdown a gene product. In some embodiments the genetic engineering is done to facilitate regeneration of tissue, to treat disease, or to improve survival of the iMN following implantation into a subject (i.e. prevent rejection). Techniques for transfecting cells are known in the art.

[00220] A skilled artisan could envision a multitude of genes which would convey beneficial properties to a iMN cell or, more indirectly, to a somatic cell, e.g., fibroblast used for transdifferentiation. The added gene may ultimately remain in the recipient cell and all its progeny, or may only remain transiently, depending on the embodiment. For example, genes encoding wild-type SODl could be transfected into a somatic cell, e.g., fibroblast. Such genes would be useful for producing iMNs with functional SODl protein where the fibroblast was obtained from a subject with an ALS-causing SODl mutation. In some situations, it may be desirable to transfect the cell with more than one gene.

[00221] In some instances, it is desirable to have the gene product secreted. In such cases, the gene product preferably contains a secretory signal sequence that facilitates secretion of the protein. For example, if the desired gene product is an angiogenic protein, a skilled artisan could either select an angiogenic protein with a native signal sequence, e.g. VEGF, or can modify the gene product to contain such a sequence using routine genetic manipulation (See Nabel et al., 1993).

[00222] The desired gene can be transfected into the cell using a variety of techniques. Preferably, the gene is transfected into the cell using an expression vector. Suitable expression vectors include plasmid vectors (such as those available from Stratagene, Madison Wis.), viral vectors (such as replication defective retroviral vectors, herpes virus, adenovirus, adeno-virus associated virus, and lentivirus), and non-viral vectors (such as liposomes or receptor ligands). [00223] The desired gene is usually operably linked to its own promoter or to a foreign promoter which, in either case, mediates transcription of the gene product. Promoters are chosen based on their ability to drive expression in restricted or in general tissue types, for example in a somatic cell, e.g., fibroblast, or on the level of expression they promote, or how they respond to added chemicals, drugs or hormones. Other genetic regulatory sequences that alter expression of a gene may be co-transfected. In some embodiments, the host cell DNA may provide the promoter and/or additional regulatory sequences. Other elements that can enhance expression can also be included such as an enhancer or a system that results in high levels of expression.

[00224] Methods of targeting genes in mammalian cells are well known to those of skill in the art (U.S.

Pat. Nos. 5,830,698; 5,789,215; 5,721,367 and 5,612,205). By "targeting genes" it is meant that the entire or a portion of a gene residing in the chromosome of a cell is replaced by a heterologous nucleotide fragment. The fragment may contain primarily the targeted gene sequence with specific mutations to the gene or may contain a second gene. The second gene may be operably linked to a promoter or may be dependent for transcription on a promoter contained within the genome of the cell. In a preferred embodiment, the second gene confers resistance to a compound that is toxic to cells lacking the gene. Such genes are typically referred to as antibiotic -resistance genes. Cells containing the gene may then be selected for by culturing the cells in the presence of the toxic compound.

Enrichment, Isolation and/or Purification of a population of iMNs.

[00225] Another aspect of the present invention relates to the isolation of a population of iMN from a heterogeneous population of cells, such a comprising a mixed population of iMN and somatic cells from which the iMNs were derived. A population of iMN produced by any of the above -described processes can be enriched, isolated and/or purified by using an affinity tag that is specific for such cells. Examples of affinity tags specific for iMN are antibodies, ligands or other binding agents that are specific to a marker molecule, such as a polypeptide, that is present on the cell surface of iMN but which is not substantially present on other cell types (i.e. on the a somatic cell, e.g., fibroblast) that would be found in the heterogeneous population of cells produced by the methods described herein. In some processes, an antibody which binds to a cell surface antigen on human iMN is used as an affinity tag for the enrichment, isolation or purification of iMN produced by in vitro methods, such as the methods described herein. Such antibodies are known and commercially available.

[00226] The skilled artisan will readily appreciate that the processes for making and using antibodies for the enrichment, isolation and/or purification of iMN are also readily adaptable for the enrichment, isolation and/or purification of iMN. For example, analyzing and sorting for iMNs using a fluorescence activated cell sorter (FACS). Antibody-bound, fluorescent cells are collected separately from non- bound, non-fluorescent, thereby resulting in the isolation of such cell types. [00227] In preferred embodiments of the processes described herein, the isolated cell composition comprising iMN can be further purified by using an alternate affinity-based method or by additional rounds of sorting using the same or different markers that are specific for iMN.

[00228] In some embodiments of the processes described herein, iMN are fluorescently labeled without the use of an antibody then isolated from non-labeled cells by using a fluorescence activated cell sorter (FACS). In such embodiments, a nucleic acid encoding GFP, YFP or another nucleic acid encoding an expressible fluorescent marker gene, such as the gene encoding luciferase, is used to label iMN using the methods described above, and as disclose in the Examples, where GFP is expressed in HB9 expressing cell. For example, in some embodiments, at least one copy of a nucleic acid encoding GFP or a biologically active fragment thereof is introduced into a somatic cell, e.g., fibroblast, preferably a human somatic cell, e.g., fibroblast, downstream of the HB9 promoter such that the expression of the GFP gene product or biologically active fragment thereof is under control of the HB9 promoter. In some embodiments, the entire coding region of the nucleic acid, which encodes HB9, is replaced by a nucleic acid encoding GFP or a biologically active fragment thereof. In other embodiments, the nucleic acid encoding GFP or a biologically active fragment thereof is fused in frame with at least a portion of the nucleic acid encoding HB9, thereby generating a fusion protein. In such embodiments, the fusion protein retains a fluorescent activity similar to GFP.

[00229] It will be appreciated that promoters other than the HB9 promoter can be used provided that the promoter corresponds to a marker that is expressed in motor neurons.

[00230] Fluorescently marked cells, such as the above-described a somatic cell, e.g., fibroblast, are

differentiated to motor neurons as described previously above. Because iMN express the fluorescent marker gene, whereas other cell types do not, iMN can be separated from the other cell types. In some embodiments, cell suspensions comprising a population of a mixture of fluorescently-labeled iMN and unlabeled non- iMNs (i.e. somatic cells, e.g., fibroblast from which the iMNs were derived) are sorted using a FACS. iMNs can be collected separately from non-fluorescing cells, thereby resulting in the isolation of iMNs. If desired, the isolated cell compositions comprising iMNs can be further purified by additional rounds of sorting using the same or different markers that are specific for motor neurons.

[00231] In preferred processes, iMNs are enriched, isolated and/or purified from other non-iMNs (i.e. from a somatic cell, e.g., fibroblast which have not been reprogrammed to become iMNs) after the cell population is induced to reprogram towards motor neurons using the methods and compositions as disclosed herein.

[00232] In addition to the procedures just described, iMNs may also be isolated by other techniques for cell isolation. Additionally, iMNs may also be enriched or isolated by methods of serial subculture in growth conditions which promote the selective survival or selective expansion of iMNs.

[00233] Using the methods described herein, enriched, isolated and/or purified populations of iMNs cells can be produced in vitro from a somatic cell, e.g., fibroblast, which has undergone sufficient transdifferentiation to produce at least some iMNs. In a preferred method, a population of somatic cells, e.g., fibroblasts can be trandifferentiated primarily into a population of iMNs, where only a portion of the somatic cell population, e.g., about 5-10% has converted to iMNs. Some preferred enrichment, isolation and/or purification methods relate to the in vitro production of iMNs from human a somatic cell, e.g., fibroblast.

[00234] Using the methods described herein, isolated cell populations of iMNs are enriched in p iMNs content by at least about 2- to about 1000-fold as compared to a population before transdifferentiation of the a somatic cell, e.g., fibroblast. In some embodiments, iMNs can be enriched by at least about 5- to about 500-fold as compared to a population before transdifferentiation of the a somatic cell, e.g., fibroblast. In other embodiments, iMNs can be enriched from at least about 10- to about 200-fold as compared to a population before transdifferentiation of the a somatic cell, e.g., fibroblast. In still other embodiments, iMNs can be enriched from at least about 20- to about 100-fold as compared to a population before transdifferentiation of the a somatic cell, e.g., fibroblast. In yet other embodiments, iMNs can be enriched from at least about 40- to about 80-fold as compared to a population before transdifferentiation of the a somatic cell, e.g., fibroblast. In certain embodiments, iMNs can be enriched from at least about 2- to about 20-fold as compared to a population before transdifferentiation of the a somatic cell, e.g., fibroblast.

Compositions Comprising iMNs

[00235] Some embodiments of the present invention relate to cell compositions, such as cell cultures or cell populations, comprising iMNs, wherein the iMNs are motor neurons which have been derived from cells e.g. human a somatic cell, e.g., fibroblast, which express or exhibit one or more characteristics of an endogenous motor neuron. In accordance with certain embodiments, the iMNs are mammalian cells, and in a preferred embodiment, such cells are human iMNs.

[00236] Other embodiments of the present invention relate to compositions, such as cell cultures or cell populations, comprising iMNs. In such embodiments, somatic cells, e.g., fibroblasts comprise less than about 90%, less than about 85%, less than about 80%, less than about 75%, less than about 70%, less than about 65%, less than about 60%, less than about 55%, less than about 50%, less than about 45%, less than about 40%, less than about 35%, less than about 30%, less than about 25%, less than about 20%, less than about 15%, less than about 12%, less than about 10%, less than about 8%, less than about 6%, less than about 5%, less than about 4%, less than about 3%, less than about 2% or less than about 1 % of the total cells in the cell population.

[00237] Certain other embodiments of the present invention relate to compositions, such as cell cultures or cell populations, comprising iMNs. In some embodiments, a somatic cell, e.g., fibroblast from which the iMNs are derived comprise less than about 25%, less than about 20%, less than about 15%, less than about 10%, less than about 5%, less than about 4%, less than about 3%, less than about 2% or less than about 1% of the total cells in the culture. In certain embodiments, iMNs comprise less than about 25%, less than about 20%, less than about 15%, less than about 10%, less than about 5%, less than about 4%, less than about 3%, less than about 2% or less than about 1% of the total cells in the culture.

[00238] Additional embodiments of the present invention relate to compositions, such as cell cultures or cell populations, produced by the processes described herein and which comprise iMNs as the majority cell type. In some embodiments, the processes described herein produce cell cultures and/or cell populations comprising at least about 99%, at least about 98%, at least about 97%, at least about 96%, at least about 95%, at least about 94%, at least about 93%, at least about 92%, at least about 91%, at least about 90%, at least about 89%, at least about 88%, at least about 87%, at least about 86%, at least about 85%, at least about 84%, at least about 83%, at least about 82%, at least about 81%, at least about 80%, at least about 79%, at least about 78%, at least about 77%, at least about 76%, at least about 75%, at least about 74%, at least about 73%, at least about 72%, at least about 71%, at least about 70%, at least about 69%, at least about 68%, at least about 67%, at least about 66%, at least about 65%, at least about 64%, at least about 63%, at least about 62%, at least about 61%, at least about 60%, at least about 59%, at least about 58%, at least about 57%, at least about 56%, at least about 55%, at least about 54%, at least about 53%, at least about 52%, at least about 51% or at least about 50% iMNs. In preferred embodiments, the cells of the cell cultures or cell populations comprise human cells. In other embodiments, the processes described herein produce cell cultures or cell populations comprising at least about 50%, at least about 45%, at least about 40%, at least about 35%, at least about 30%, at least about 25%, at least about 24%, at least about 23%, at least about 22%, at least about 21%, at least about 20%, at least about 19%, at least about 18%, at least about 17%, at least about 16%, at least about 15%, at least about 14%, at least about 13%, at least about 12%, at least about IT %, at least about 10%, at least about 9%, at least about 8%, at least about 7%, at least about 6%, at least about 5%, at least about 4%, at least about 3%, at least about 2% or at least about 1% iMNs. In preferred embodiments, the cells of the cell cultures or cell populations comprise human cells. In some embodiments, the percentage of iMNs in the cell cultures or populations is calculated without regard to the feeder cells remaining in the culture.

[00239] Still other embodiments of the present invention relate to compositions, such as cell cultures or cell populations, comprising mixtures of iMNs and a somatic cell, e.g., fibroblast. For example, cell cultures or cell populations comprising at least about 5 iMNs for about every 95 somatic cell, e.g., fibroblast can be produced. In other embodiments, cell cultures or cell populations comprising at least about 95 iMNs for about every 5 somatic cell, e.g., fibroblast can be produced. Additionally, cell cultures or cell populations comprising other ratios of iMNs to somatic cell, e.g., fibroblast are contemplated. For example, compositions comprising at least about 1 iMNs for about every 1,000,000, or at least 100,000 cells, or a least 10,000 cells, or at least 1000 cells or 500, or at least 250 or at least 100 or at least 10 somatic cell, e.g., fibroblast. Further embodiments of the present invention relate to compositions, such as cell cultures or cell populations, comprising human cells, including human iMNs. [00240] In preferred embodiments of the present invention, cell cultures and/or cell populations of iMNs comprise human iMNs that are non-recombinant cells. In such embodiments, the cell cultures and/or cell populations are devoid of or substantially free of recombinant human iMNs.

[00241] Using the processes described herein, compositions comprising iMNs are substantially free of other cell types can be produced. In some embodiments of the present invention, the iMNs populations or cell cultures produced by the methods described herein are substantially free of cells that significantly express the fibroblast markers, or non-motor neuron markers.

Use of the iMNs

[00242] Another aspect of the present invention further provides a method of treating a subject with a motor neuron disease or disorder, or treating a subject at risk of developing a motor neuron disease or disorder, comprising administering to the subject a composition comprising a population of iMNs. In some embodiments the motor neuron disease or disorder is amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy (SMA).

[00243] In some embodiments, the present invention also provides a method of treating a motor neuron disease or disorder in a subject, comprising obtaining a population of a somatic cell, e.g., fibroblast from a subject, e.g. from the subject being treated, or from a donor subject; increasing the protein expression of at least three, or all three transcription factors selected Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl in the population of a somatic cell, e.g., fibroblast in vitro, for example by the methods as described herein, thereby promoting conversion of the population of a somatic cell, e.g., fibroblast into iMNs; and administering a substantially pure population of iMNs to the subject.

[00244] In the method of treating a motor neuron disease, wherein a somatic cell, e.g., fibroblast can be from a donor, the donor can be a cadaver. As a further embodiment of the present invention, the a somatic cell, e.g., fibroblast can be allowed to proliferate in vitro prior to increasing the protein expression of at least three or more MN-inducing factors selected from any combination of Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl. Preferably, promoting conversion of a somatic cell, e.g., fibroblast into iMN as disclosed herein will result in greater than about 5% or about 10% of conversion of a somatic cell, e.g., fibroblast into iMN. Even more preferably, greater than about 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, or 90% of the a somatic cell, e.g., fibroblast will be converted into iMNs.

[00245] In some embodiments, the iMNs as disclosed herein can be used in cellular models of human motor neuron disease, where such models could be used for basic research and drug discovery, e.g., to find treatments for motor neuron diseases or disorders including but not limited to: amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease or classical motor neuron disease; progressive bulbar palsy, also called progressive bulbar atrophy; pseudobulbar palsy; primary lateral sclerosis (PLS);

progressive muscular atrophy; spinal muscular atrophy (SMA, including SMA type I, also called Werdnig-Hoffmann disease, SMA type II, and SMA type III, also called Kugelberg-Welander disease); Fazio-Londe disease; Kennedy disease, also known as progressive spinobulbar muscular atrophy;

congenital SMA with arthrogryposis or post-polio syndrome (PPS).

[00246] In an exemplary embodiment, gene therapy can be used to insert DNA into a fibroblast which is transdifferentiated into a iMN, where the fibroblast is from a patient or subject with a genetic defect or a defect of unknown origin in their motor neurons, followed by the transdifferentiation of the fibroblast into a iMN. The thus formed iMN population may then be used as a cellular model for the disorder associated with the genetic defect or any other abnormality carried by these cells. In some embodiments, the cellular model may be used for the development of drugs. In addition, a population of iMNs transdifferentiated from fibroblasts obtained from a subject with a motor neuron disease may serve for drug development and testing for the specific patient from which they were developed in the course of personalized medicine.

[00247] In an other exemplary embodiment stem cell, neural precursors or neural progenitors may be

developed from any source of somatic cells, e.g., the gonads, bone marrow, brain biopsy or any transdifferentiation of somatic cells obtained from a patient with motor neuron disorder of any etiology, and directed to convert by transdifferentiation method as disclosed herein into a population of motor neurons. Such a iMN population may then be used as a cellular model for the motor neuron disorder of the patient. The cellular model may be used for the development of drugs. In addition, the thus formed population may serve for drug development and testing for the specific patient from which they were developed in the course of personalized medicine.

[00248] In some embodiments, an iMN population as disclosed herein may serve for testing and high

throughput screening of molecules for neurotoxic, teratogenic, neurotrophic, neuroprotective and neuroregenerative effects. In accordance with another embodiment, the iMNs can be used for studying exogenous diseases and disorders of motor neurons. In one exemplary embodiment, the iMNs can be used to study viral infections of motor neurons such as polio.

[00249] In some embodiments, altering the surface antigens of the iMNs produced by the methods as

disclosed herein can reduce the likelihood that iMNs will cause an immune response. The iMNs with altered surface antigens can then be administered to the subject. The cell surface antigens can be altered prior to, during, or after the fibroblasts are trandifferentiated into iMNs.

[00250] The subject of the invention can include individual humans, domesticated animals, livestock (e.g., cattle, horses, pigs, etc.), pets (like cats and dogs).

[00251] Accordingly, the methods for treatment as described herein can be combined with other methods of treating motor neuron diseases which are known by a skilled physician in the art of neurological treatment of motor neuron diseases.

Kits

[00252] The cells and components such as one or more MN-inducing factors can be provided in a kit. The kit includes (a) the cells and components described herein, e.g., a composition(s) that includes a cell and component(s) described herein, and, optionally (b) informational material. The informational material can be descriptive, instructional, marketing or other material that relates to the methods described herein and/or the use of a compound(s) described herein for the methods described herein.

[00253] The informational material of the kits is not limited in its form. In one embodiment, the

informational material can include information about production of a cell, the nature of the components such as the transcription factor, concentration of components, date of expiration, batch or production site information, and so forth. In one embodiment, the informational material relates to methods for administering the cells or other components.

[00254] In one embodiment, the informational material can include instructions to administer a

compound(s) component such as a transcription factor described herein in a suitable manner to perform the methods described herein, e.g., in a suitable dose, dosage form, or mode of administration (e.g., a dose, dosage form, or mode of administration described herein) (e.g., to a cell in vitro or a cell in vivo). In another embodiment, the informational material can include instructions to administer a component(s) described herein to a suitable subject, e.g., a human, e.g., a human having or at risk for a disorder described herein or to a cell in vitro.

[00255] The informational material of the kits is not limited in its form. In many cases, the informational material, e.g., instructions, is provided in printed matter, e.g., a printed text, drawing, and/or photograph, e.g., a label or printed sheet. However, the informational material can also be provided in other formats, such as Braille, computer readable material, video recording, or audio recording. In another embodiment, the informational material of the kit is contact information, e.g., a physical address, email address, website, or telephone number, where a user of the kit can obtain substantive information about a compound described herein and/or its use in the methods described herein. Of course, the

informational material can also be provided in any combination of formats.

[00256] In addition to a compound(s) described herein, the composition of the kit can include other

ingredients, such as a solvent or buffer, a stabilizer, a preservative, and/or an additional agent, e.g., for reprogramming a somatic cell, e.g., fibroblast, such as a somatic cell (e.g., in vitro or in vivo) or for treating a condition or disorder described herein. Alternatively, the other ingredients can be included in the kit, but in different compositions or containers than a component described herein. In such embodiments, the kit can include instructions for admixing a component(s) described herein and the other ingredients, or for using a component(s) described herein together with the other ingredients, e.g., instructions on combining the two agents prior to administration.

[00257] The kit can include one or more containers for the composition containing a component(s)

described herein. In some embodiments, the kit contains separate containers (e.g., two separate containers for the two agents), dividers or compartments for the component(s) and informational material. For example, the composition can be contained in a bottle, vial, or syringe, and the informational material can be contained in a plastic sleeve or packet. In other embodiments, the separate elements of the kit are contained within a single, undivided container. For example, the composition is contained in a bottle, vial or syringe that has attached thereto the informational material in the form of a label. In some embodiments, the kit includes a plurality (e.g., a pack) of individual containers, each containing one or more unit dosage forms (e.g., a dosage form described herein) of a compound described herein. For example, the kit includes a plurality of syringes, ampules, foil packets, or blister packs, each containing a single unit dose of a component described herein. The containers of the kits can be air tight, waterproof (e.g., impermeable to changes in moisture or evaporation), and/or light-tight.

[00258] The kit optionally includes a device suitable for administration of the component, e.g., a syringe, inhalant, pipette, forceps, measured spoon, dropper (e.g., eye dropper), swab (e.g., a cotton swab or wooden swab), or any such delivery device.

Pharmaceutical compositions comprising a population of iMNs.

[00259] In another aspect of the invention, the methods provide use of an isolated population of iMNs as disclosed herein. In one embodiment of the invention, an isolated population of iMNs as disclosed herein may be used for the production of a pharmaceutical composition, for the use in transplantation into subjects in need of treatment, e.g. a subject that has, or is at risk of developing a motor neuron disease or disorder, for example but not limited to subjects with congenital and acquired ALS or SMA. In one embodiment, an isolated population of iMNs may be genetically modified. In another aspect, the subject may have or be at risk of a motor neuron disease, e.g., carry a particular mutation for susceptibility for ALS by has not yet observed or detected ALS symptoms. In some embodiments, an isolated population of iMNs as disclosed herein may be autologous and/or allogenic. In some embodiments, the subject is a mammal, and in other embodiments the mammal is a human.

[00260] The use of an isolated population of iMNs as disclosed herein provides advantages over existing methods because the iMNs can be reprogrammed from a somatic cell, e.g., fibroblast obtained or harvested from the subject administered an isolated population of iMNs. This is highly advantageous as it provides a renewable source of functional motor neurons for transplantation into a subject, in particular a substantially pure population of iMNs that do not have the risks and limitations of iMNs derived from other systems, such as from iPS cells which have risks of formation of teratomas

(Lafamme and Murry, 2005, Murry et al, 2005; Rubart and Field, 2006).

[00261] In another embodiment, an isolated population of p iMNs can be used as models for studying properties of motor neurons, or pathways of development of a somatic cell, e.g., fibroblast into motor neuron cells. In some embodiments, the iMNs cells may be genetically engineered to comprise markers operatively linked to promoters that are expressed when a marker is expressed or secreted, for example, a marker can be operatively linked to Hb9 promoter, so that the marker is expressed when the cell becomes a functional motor neuron. In some embodiments, a population of iMNs can be used as a model for studying the differentiation pathway of cells which differentiate into motor neurons. In other embodiments, the iMNs may be used as models for studying the role of motor neurons in development and in the development of motor neuron disease or disorders. In some embodiments, the iMNs can be from a normal subject, or from a subject which carries a mutation and/or polymorphism (e.g. a mutation in the SOD1 gene is one form of the inherited form of ALS), as well as effect of mutations on late onset ALS, which can be use to identify small molecules and other therapeutic agents that can be used to treat subjects with ALS with such mutations or polymorphism in ALS associated genes. In some

embodiments, the iMNs may be genetically engineered to correct the polymorphism in the SOD1 gene, or other ALS susceptibility genes, including but not limited to, heavy neurofilament chain (NFH), dynactin, vescicular binding protein 1 gene and the ALSIN (ALS2) gene, prior to being administered to a subject in the therapeutic treatment of a subject with ALS. In some embodiments, the iMNs may be genetically engineered to carry a mutation and/or polymorphism for studying the effects of the mutation and/or polymorphism on the development and contribution to the motor neuron disease.

[00262] In one embodiment of the invention relates to a method of treating a motor neuron disease, e.g., ALS or SMA in a subject comprising administering an effective amount of a composition comprising a population of iMNs as disclosed herein to a subject with a motor neuron disease, e.g., ALS or SMA. In a further embodiment, the invention provides a method for treating a motor neuron disease, e.g., ALS or SMA, comprising administering a composition comprising a population of iMNs as disclosed herein to a subject that has, or has increased risk of developing a motor neuron disease, e.g., ALS or SMA, in an effective amount sufficient to produce motor neurons which can support degenerating or dying motor neurons in the subject.

[00263] In some embodiments, a population of iMNs can be administered to a subject in combination with other treatment for motor neuron diseases, such as, for example, administration on combination with riluzole, RNA interference (RNAi) for ALS susceptibility or mutated genes (e.g., RNAi of mutant SOD1 genes, or RNAi for any of the mutant NFH, dynactin, vesicular binding protein or ALSIN genes), neurotrophic factors (e.g., IGF-1, EPO, CTNF, BDNF, VEGF), anti-oxidative agents such as HIF-loc, amino acids, e.g.,. creatine, as well as small molecules drugs such as ceftriaxone, lithium, xaliproden, pioglitazone, pyridostigmine and seligiline and other agents or stem cells, e.g, embryonic stem cells used for the treatment of motor neuron diseases.

[00264] In one embodiment of the above methods, the subject is a human and a population of iMNs as disclosed herein are human cells. In some embodiments, the invention contemplates that a population of iMNs as disclosed herein are administered directly to the spinal cord of a subject, or is administered systemically. In some embodiments, a population of iMNs as disclosed herein can be administered to any suitable location in the subject, for example in a capsule in the blood vessel or any suitable site where administered population of iMNs can integrate into the spinal cord and send axonal projections which make synaptic contact with the muscle tissues in the subject.

[00265] The present invention is also directed to a method of treating a subject with a motor neuron

disease, e.g., ALS or SMA which occurs as a consequence of genetic defect, physical injury, environmental insult or conditioning, bad health, obesity and other a motor neuron disease risk factors commonly known by a person of ordinary skill in the art. Efficacy of treatment can be monitored by clinically accepted criteria and tests, which include for example, using Electromyography (EMG), which is used to diagnose muscle and nerve dysfunction and spinal cord disease, and measure the speed at which impulses travel along a particular nerve. EMG records the electrical activity from the brain and/or spinal cord to a peripheral nerve root (found in the arms and legs) that controls muscles during contraction and at rest. One can also monitor efficacy of treatment using a nerve conduction velocity study to measure electrical energy to test the nerve's ability to send a signal, as well as laboratory screening tests of blood, urine, as well as magnetic resonance imaging (MRI), which uses computer- generated radio waves and a powerful magnetic field to produce detailed images of body structures including tissues, organs, bones, and nerves to detect and monitor degenerative disorders. In some embodiments, efficacy of treatment can also be assessed by a muscle or nerve biopsy can help confirm nerve disease and nerve regeneration. A small sample of the muscle or nerve is removed under local anesthetic and studied under a microscope. The sample may be removed either surgically, through a slit made in the skin, or by needle biopsy, in which a thin hollow needle is inserted through the skin and into the muscle. A small piece of muscle remains in the hollow needle when it is removed from the body. In some embodiments, efficacy of treatment can also be monitored by a transcranial magnetic stimulation to study areas of the brain related to motor activity.

[00266] Other motor neuron diseases which can be treated by the methods as disclosed herein include, but are not limited to: Amyotrophic lateral sclerosis (ALS), Progressive bulbar palsy, Pseudobulbar palsy, Primary lateral sclerosis (PLS), Progressive muscular atrophy, Spinal muscular atrophy (SMA), including Type I (also called Werdnig-Hoffmann disease), Type II, Type III (Kugelberg-Welander disease), Fazio-Londe disease, Kennedy's disease also known as progressive spinobulbar muscular atrophy; congenital SMA with arthrogryposis, Post-polio syndrome (PPS) and traumatic spinal cord injury.

[00267] ALS, also called Lou Gehrig's disease or classical motor neuron disease, is a progressive,

ultimately fatal disorder that eventually disrupts signals to all voluntary muscles. In the United States, doctors use the terms motor neuron disease and ALS interchangeably. Both upper and lower motor neurons are affected. Approximately 75 percent of people with classic ALS will also develop weakness and wasting of the bulbar muscles (muscles that control speech, swallowing, and chewing). Symptoms are usually noticed first in the arms and hands, legs, or swallowing muscles. Muscle weakness and atrophy occur disproportionately on both sides of the body. Affected individuals lose strength and the ability to move their arms, legs, and body. Other symptoms include spasticity, exaggerated reflexes, muscle cramps, fasciculations, and increased problems with swallowing and forming words. Speech can become slurred or nasal. When muscles of the diaphragm and chest wall fail to function properly, individuals lose the ability to breathe without mechanical support. Although the disease does not usually impair a person's mind or personality, several recent studies suggest that some people with ALS may have alterations in cognitive functions such as problems with decision-making and memory. ALS most commonly strikes people between 40 and 60 years of age, but younger and older people also can develop the disease. Men are affected more often than women. Most cases of ALS occur sporadically, and family members of those individuals are not considered to be at increased risk for developing the disease. (There is a familial form of ALS in adults, which often results from mutation of the superoxide dismutase gene, or SOD1, located on chromosome 21.) A rare juvenile-onset form of ALS is genetic. Most individuals with ALS die from respiratory failure, usually within 3 to 5 years from the onset of symptoms. However, about 10 percent of affected individuals survive for 10 or more years.

[00268] Progressive bulbar palsy, also called progressive bulbar atrophy, involves the bulb-shaped brain stem— the region that controls lower motor neurons needed for swallowing, speaking, chewing, and other functions. Symptoms include pharyngeal muscle weakness (involved with swallowing), weak jaw and facial muscles, progressive loss of speech, and tongue muscle atrophy. Limb weakness with both lower and upper motor neuron signs is almost always evident but less prominent. Affected persons have outbursts of laughing or crying (called emotional lability). Individuals eventually become unable to eat or speak and are at increased risk of choking and aspiration pneumonia, which is caused by the passage of liquids and food through the vocal folds and into the lower airways and lungs. Stroke and myasthenia gravis each have certain symptoms that are similar to those of progressive bulbar palsy and must be ruled out prior to diagnosing this disorder. In about 25 percent of ALS cases early symptoms begin with bulbar involvement. Some 75 percent of individuals with classic ALS eventually show some bulbar involvement. Many clinicians believe that progressive bulbar palsy by itself, without evidence of abnormalities in the arms or legs, is extremely rare.

[00269] Pseudobulbar palsy, which shares many symptoms of progressive bulbar palsy, is characterized by upper motor neuron degeneration and progressive loss of the ability to speak, chew, and swallow.

Progressive weakness in facial muscles leads to an expressionless face. Individuals may develop a gravelly voice and an increased gag reflex. The tongue may become immobile and unable to protrude from the mouth. Individuals may also experience emotional lability.

[00270] Primary lateral sclerosis (PLS) affects only upper motor neurons and is nearly twice as common in men as in women. Onset generally occurs after age 50. The cause of PLS is unknown. It occurs when specific nerve cells in the cerebral cortex (the thin layer of cells covering the brain which is responsible for most higher level mental functions) that control voluntary movement gradually degenerate, causing the muscles under their control to weaken. The syndrome— which scientists believe is only rarely hereditary— progresses gradually over years or decades, leading to stiffness and clumsiness of the affected muscles. The disorder usually affects the legs first, followed by the body trunk, arms and hands, and, finally, the bulbar muscles. Symptoms may include difficulty with balance, weakness and stiffness in the legs, clumsiness, spasticity in the legs which produces slowness and stiffness of movement, dragging of the feet (leading to an inability to walk), and facial involvement resulting in dysarthria (poorly articulated speech). Major differences between ALS and PLS (considered a variant of ALS) are the motor neurons involved and the rate of disease progression. PLS may be mistaken for spastic paraplegia, a hereditary disorder of the upper motor neurons that causes spasticity in the legs and usually starts in adolescence. Most neurologists follow the affected individual's clinical course for at least 3 years before making a diagnosis of PLS. The disorder is not fatal but may affect quality of life. PLS often develops into ALS.

[00271] Progressive muscular atrophy is marked by slow but progressive degeneration of only the lower motor neurons. It largely affects men, with onset earlier than in other MNDs. Weakness is typically seen first in the hands and then spreads into the lower body, where it can be severe. Other symptoms may include muscle wasting, clumsy hand movements, fasciculations, and muscle cramps. The trunk muscles and respiration may become affected. Exposure to cold can worsen symptoms. The disease develops into ALS in many instances.

[00272] Spinal muscular atrophy (SMA) is a hereditary disease affecting the lower motor neurons.

Weakness and wasting of the skeletal muscles is caused by progressive degeneration of the anterior horn cells of the spinal cord. This weakness is often more severe in the legs than in the arms. SMA has various forms, with different ages of onset, patterns of inheritance, and severity and progression of symptoms. Some of the more common SMAs are described below.

[00273] SMA type I, also called Werdnig-Hojfmann disease, is evident by the time a child is 6 months old.

Symptoms may include hypotonia (severely reduced muscle tone), diminished limb movements, lack of tendon reflexes, fasciculations, tremors, swallowing and feeding difficulties, and impaired breathing. Some children also develop scoliosis (curvature of the spine) or other skeletal abnormalities. Affected children never sit or stand and the vast majority usually die of respiratory failure before the age of 2. Symptoms of SMA type II usually begin after the child is 6 months of age. Features may include inability to stand or walk, respiratory problems, hypotonia, decreased or absent tendon reflexes, and fasciculations. These children may learn to sit but do not stand. Life expectancy varies, and some individuals live into adolescence or later. Symptoms of SMA type III (Kugelberg-Welander disease) appear between 2 and 17 years of age and include abnormal gait; difficulty running, climbing steps, or rising from a chair; and a fine tremor of the fingers. The lower extremities are most often affected. Complications include scoliosis and joint contractures— chronic shortening of muscles or tendons around joints, caused by abnormal muscle tone and weakness, which prevents the joints from moving freely.

[00274] Symptoms of Fazio-Londe disease appear between 1 and 12 years of age and may include facial weakness, dysphagia (difficulty swallowing), stridor (a high-pitched respiratory sound often associated with acute blockage of the larynx), difficulty speaking (dysarthria), and paralysis of the eye muscles. Most individuals with SMA type III die from breathing complications.

[00275] Kennedy disease, also known as progressive spinobulbar muscular atrophy, is an X-linked

recessive disease. Daughters of individuals with Kennedy disease are carriers and have a 50 percent chance of having a son affected with the disease. Onset occurs between 15 and 60 years of age.

Symptoms include weakness of the facial and tongue muscles, hand tremor, muscle cramps, dysphagia, dysarthria, and excessive development of male breasts and mammary glands. Weakness usually begins in the pelvis before spreading to the limbs. Some individuals develop noninsulin-dependent diabetes mellitus. The course of the disorder varies but is generally slowly progressive. Individuals tend to remain ambulatory until late in the disease. The life expectancy for individuals with Kennedy disease is usually normal. Congenital SMA with arthrogryposis (persistent contracture of joints with fixed abnormal posture of the limb) is a rare disorder. Manifestations include severe contractures, scoliosis, chest deformity, respiratory problems, unusually small jaws, and drooping of the upper eyelids.

[00276] Post-polio syndrome (PPS) is a condition that can strike polio survivors decades after their

recovery from poliomyelitis. PPS is believed to occur when injury, illness (such as degenerative joint disease), weight gain, or the aging process damages or kills spinal cord motor neurons that remained functional after the initial polio attack. Many scientists believe PPS is latent weakness among muscles previously affected by poliomyelitis and not a new MND. Symptoms include fatigue, slowly progressive muscle weakness, muscle atrophy, fasciculations, cold intolerance, and muscle and joint pain. These symptoms appear most often among muscle groups affected by the initial disease. Other symptoms include skeletal deformities such as scoliosis and difficulty breathing, swallowing, or sleeping.

Symptoms are more frequent among older people and those individuals most severely affected by the earlier disease. Some individuals experience only minor symptoms, while others develop SMA and, rarely, what appears to be, but is not, a form of ALS. PPS is not usually life threatening. Doctors estimate the incidence of PPS at about 25 to 50 percent of survivors of paralytic poliomyelitis.

[00277] In some embodiments, the effects of administration of a population of iMNs as disclosed herein to a subject in need thereof is associated with improved exercise tolerance or other quality of life measures, and decreased mortality. The effects of cellular therapy can be evident over the course of days to weeks after the procedure. However, beneficial effects may be observed as early as several hours after the procedure, and may persist for several years.

[00278] In some embodiments, the iMNs can be used for transplantation into any tissue of interest, where such tissues could be neural tissues (central nervous system or peripheral nervous system, e.g. spinal cord, nerve bundles, motor nerves, nerve ganglia) or non-neural tissues (muscle, liver, lungs). The iMNs can be transplanted into the spinal cord at any position from the cervical to lumbar regions. One of skill in the art can determine what procedures would be necessary for transplanting the cells into a particular position in the spinal cord, e.g., in some embodiments, a laminectomy may be appropriate to facility entry to the spinal cord, while in other embodiments the cells could be administered by directly accessing the spinal cord, as may be possible for neonatal applications, or administration to adult subjects by inserted the injection apparatus between vertebral bodies (similar to a spinal tap), to deliver the cells either into nervous tissue or intra thecal or into any other appropriate site.

[00279] In accordance with one aspect of the invention, when the iMNs are used in a therapeutic

application wherein the cells are expected to exhibit functions similar or identical to motor neuron functions. In one embodiment, the iMNs are transplanted using procedures to target the cells to selected sites. In an exemplary embodiment, when iMNs are introduced into the spinal cord, the cells may be targeted to spinal cord grey matter, including the dorsal or ventral horn of the grey matter. In another exemplary embodiment, iMNs can be targeted to other sites including, but not limited to, an emerging ventral or dorsal root, a dorsal root ganglion, a spinal nerve, a peripheral nerve a motor nerve, or any other appropriate site as determined by one of skill in the art. In one embodiment, the iMNs are transplanted directly or indirectly (e.g. ex vivo) to mammals, preferably, to humans.

[00280] In some other embodiments, the iMNs can be used as carriers for gene therapy, or as carriers for protein delivery.

[00281] In some embodiments, a population of iMNs as disclosed herein may be used for tissue

reconstitution or regeneration in a human patient or other subject in need of such treatment. The cells are administered in a manner that permits them to graft or migrate to the intended tissue site and reconstitute or regenerate the functionally deficient area. Special devices are available that are adapted for administering cells capable of reconstituting a population of iMNs as disclosed herein into the spinal cord or at an alternative desired location. The cells may be administered to a recipient by injection, or administered by intramuscular injection.

[00282] To determine the suitability of cell compositions for therapeutic administration, the cells can first be tested in a suitable animal model. At one level, cells are assessed for their ability to survive and maintain their phenotype in vivo. Cell compositions can be administered to immunodeficient animals (such as nude mice, or animals rendered immunodeficient chemically or by irradiation). Tissues are harvested after a period of regrowth, and assessed as to whether the administered cells or progeny thereof are still present.

[00283] This can be performed by administering cells that express a detectable label (such as green

fluorescent protein, or beta-galactosidase); that have been prelabeled (for example, with BrdU or [3H] thymidine), or by subsequent detection of a constitutive cell marker (for example, using human-specific antibody). The presence and phenotype of the administered population of iMNs can be assessed by immunohistochemistry or ELISA using human-specific antibody, or by RT-PCR analysis using primers and hybridization conditions that cause amplification to be specific for human polynucleotides, according to published sequence data.

[00284] A number of animal models for testing in models of motor neuron diseases are available for such testing, and are commonly known in the art, for example as the S0D1(G93A) mutant mouse and SMA (B6.129-Smnl^{tmlJme J}) mouse models from Jackson laboratories.

[00285] In some embodiments, a population of iMNs as disclosed herein may be administered in any

physiologically acceptable excipient, where the cells may find an appropriate site for regeneration and differentiation. In some embodiments, a population of iMNs as disclosed herein can be introduced by injection, catheter, or the like. In some embodiments, a population of iMNs as disclosed herein can be frozen at liquid nitrogen temperatures and stored for long periods of time, being capable of use on thawing. If frozen, a population of iMNs will usually be stored in a 10% DMSO, 50% FCS, 40% RPMI 1640 medium. Once thawed, the cells may be expanded by use of growth factors and/or feeder cells associated with culturing iMNs as disclosed herein.

[00286] In some embodiments, a population of iMNs as disclosed herein can be supplied in the form of a pharmaceutical composition, comprising an isotonic excipient prepared under sufficiently sterile conditions for human administration. For general principles in medicinal formulation, the reader is referred to Cell Therapy: Stem Cell Transplantation, Gene Therapy, and Cellular Immunotherapy, by G. Morstyn & W. Sheridan eds, Cambridge University Press, 1996; and Hematopoietic Stem Cell Therapy, E. D. Ball, J. Lister & P. Law, Churchill Livingstone, 2000. Choice of the cellular excipient and any accompanying elements of the composition comprising a population of iMNs as disclosed herein will be adapted in accordance with the route and device used for administration. In some embodiments, a composition comprising a population of iMNs can also comprise or be accompanied with one or more other ingredients that facilitate the engraftment or functional mobilization of the iMNs. Suitable ingredients include matrix proteins that support or promote adhesion of the iMNs, or complementary cell types, especially glial and/or muscle cells. In another embodiment, the composition may comprise resorbable or biodegradable matrix scaffolds.

[00287] In some embodiments, a population of iMNs as disclosed herein may be genetically altered in order to introduce genes useful in the iMNs, e.g. repair of a genetic defect in an individual, selectable marker, etc., or genes useful in selection against non-iMNs or for the selective suicide of implanted iMNs. In some embodiments, a population of iMNs can also be genetically modified to enhance survival, control proliferation, and the like. In some embodiments, a population of iMNs as disclosed herein can be genetically altering by transfection or transduction with a suitable vector, homologous recombination, or other appropriate technique, so that they express a gene of interest. In one embodiment, a iMNs is transfected with genes encoding a telomerase catalytic component (TERT), typically under a heterologous promoter that increases telomerase expression beyond what occurs under the endogenous promoter, (see International Patent Application WO 98/14592, which is incorporated herein by reference). In other embodiments, a selectable marker is introduced, to provide for greater purity of the population of iMNs. In some embodiments, a population of iMNs may be genetically altered using vector containing supernatants over a 8-16 h period, and then exchanged into growth medium for 1-2 days. Genetically altered iMNs can be selected using a drug selection agent such as puromycin, G418, or blasticidin, and then recultured.

[00288] Gene therapy can be used to either modify a cell to replace a gene product, to facilitate

regeneration of tissue, to treat disease, or to improve survival of the cells following implantation into a subject (i.e. prevent rejection).

[00289] In an alternative embodiment, a population of iMNs as disclosed herein can also be genetically altered in order to enhance their ability to be involved in tissue regeneration, or to deliver a therapeutic gene to a site of administration. A vector is designed using the known encoding sequence for the desired gene, operatively linked to a promoter that is either pan-specific or specifically active in the

differentiated cell type. [00290] Many vectors useful for transferring exogenous genes into target iMNs as disclosed herein are available. The vectors may be episomal, e.g. plasmids, virus derived vectors such as cytomegalovirus, adenovirus, etc., or may be integrated into the target cell genome, through homologous recombination or random integration, e.g. retrovirus derived vectors such MMLV, HIV-1, ALV, etc. In some

embodiments, combinations of retroviruses and an appropriate packaging cell line may also find use, where the capsid proteins will be functional for infecting the iMNs as disclosed herein. Usually, iMNs and virus will be incubated for at least about 24 hours in the culture medium. In some embodiments, iMNs are then allowed to grow in the culture medium for short intervals in some applications, e.g. 24-73 hours, or for at least two weeks, and may be allowed to grow for five weeks or more, before analysis. Commonly used retroviral vectors are "defective", i.e. unable to produce viral proteins required for productive infection. Replication of the vector requires growth in the packaging cell line.

[00291] The host cell specificity of the retrovirus is determined by the envelope protein, env (pi 20). The envelope protein is provided by the packaging cell line. Envelope proteins are of at least three types, ecotropic, amphotropic and xenotropic. Retroviruses packaged with ecotropic envelope protein, e.g. MMLV, are capable of infecting most murine and rat cell types. Ecotropic packaging cell lines include BOSC23 (Pear et al. (1993) P.N.A.S. 90:8392-8396). Retroviruses bearing amphotropic envelope protein, e.g. 4070A (Danos et al, supra.), are capable of infecting most mammalian cell types, including human, dog and mouse. Amphotropic packaging cell lines include PA12 (Miller et al. (1985) Mol. Cell. Biol. 5:431-437); PA317 (Miller et al. (1986) Mol. Cell. Biol. 6:2895-2902) GRIP (Danos et al. (1988) PNAS 85:6460-6464). Retroviruses packaged with xenotropic envelope protein, e.g. AKR env, are capable of infecting most mammalian cell types, except murine cells. In some embodiments, the vectors may include genes that must later be removed, e.g. using a recombinase system such as Cre/Lox, or the cells that express them destroyed, e.g. by including genes that allow selective toxicity such as herpesvirus TK, Bcl-Xs, etc.

[00292] Suitable inducible promoters are activated in a desired target cell type, either the transfected cell, or progeny thereof. By transcriptional activation, it is intended that transcription will be increased above basal levels in the target cell by at least about 100 fold, more usually by at least about 1000 fold. Various promoters are known that are induced in different cell types.

[00293] In one aspect of the present invention, a population of iMNs as disclosed herein are suitable for administering systemically or to a target anatomical site. A population of iMNs can be grafted into or nearby a subject's spinal cord, for example, or may be administered systemically, such as, but not limited to, intra-arterial or intravenous administration. In alternative embodiments, a population of iMNs of the present invention can be administered in various ways as would be appropriate to implant in the central nervous system or peripheral nervous system, including but not limited to parenteral, including intravenous and intraarterial administration, intrathecal administration, intraventricular administration, intraparenchymal, intracranial, intracisternal, intrastriatal, and intranigral administration. Optionally, a population of iMNs can be administered in conjunction with an immunosuppressive agent. [00294] In some embodiments, a population of iMNs can be administered and dosed in accordance with good medical practice, taking into account the clinical condition of the individual patient, the site and method of administration, scheduling of administration, patient age, sex, body weight and other factors known to medical practitioners. The pharmaceutically "effective amount" for purposes herein is thus determined by such considerations as are known in the art. The amount must be effective to achieve improvement, including but not limited to improved survival rate or more rapid recovery, or improvement or elimination of symptoms and other indicators as are selected as appropriate measures by those skilled in the art. A population of iMNs can be administered to a subject the following locations: clinic, clinical office, emergency department, hospital ward, intensive care unit, operating room, catheterization suites, and radiologic suites.

[00295] In other embodiments, a population of iMNs is stored for later implantation/infusion. A population of iMNs may be divided into more than one aliquot or unit such that part of a population of iMNs is retained for later application while part is applied immediately to the subject. Moderate to long-term storage of all or part of the cells in a cell bank is also within the scope of this invention, as disclosed in U.S. Patent Application Serial No. 20030054331 and Patent Application No. WO03024215, and is incorporated by reference in their entireties. At the end of processing, the concentrated cells may be loaded into a delivery device, such as a syringe, for placement into the recipient by any means known to one of ordinary skill in the art.

[00296] In some embodiments, a population of iMNs can be applied alone or in combination with other cells, tissue, tissue fragments, growth factors such as VEGF and other known angiogenic or arteriogenic growth factors, biologically active or inert compounds, resorbable plastic scaffolds, or other additive intended to enhance the delivery, efficacy, tolerability, or function of the population. In some embodiments, a population of iMNs may also be modified by insertion of DNA or by placement in cell culture in such a way as to change, enhance, or supplement the function of the cells for derivation of a structural or therapeutic purpose. For example, gene transfer techniques for stem cells are known by persons of ordinary skill in the art, as disclosed in (Morizono et al., 2003; Mosca et al., 2000), and may include viral transfection techniques, and more specifically, adeno-associated virus gene transfer techniques, as disclosed in (Walther and Stein, 2000) and (Athanasopoulos et al., 2000). Non-viral based techniques may also be performed as disclosed in (Murarnatsu et al., 1998).

[00297] In another aspect, in some embodiments, a population of iMNs could be combined with a gene encoding pro-angiogenic growth factor(s). Genes encoding anti-apoptotic factors or agents could also be applied. Addition of the gene (or combination of genes) could be by any technology known in the art including but not limited to adenoviral transduction, "gene guns," liposome-mediated transduction, and retrovirus or lentivirus-mediated transduction, plasmid' adeno-associated virus. Cells could be implanted along with a carrier material bearing gene delivery vehicle capable of releasing and/or presenting genes to the cells over time such that transduction can continue or be initiated. Particularly when the cells and/or tissue containing the cells are administered to a patient other than the patient from whom the cells and/or tissue were obtained, one or more immunosuppressive agents may be administered to the patient receiving the cells and/or tissue to reduce, and preferably prevent, rejection of the transplant. As used herein, the term "immunosuppressive drug or agent" is intended to include pharmaceutical agents which inhibit or interfere with normal immune function. Examples of immunosuppressive agents suitable with the methods disclosed herein include agents that inhibit T-cell/B- cell co-stimulation pathways, such as agents that interfere with the coupling of T-cells and B-cells via the CTLA4 and B7 pathways, as disclosed in U.S. Patent Pub. No 2002/0182211, which is incorporated herein by reference. In one embodiment, an immunosuppressive agent is cyclosporine A. Other examples include myophenylate mofetil, rapamicin, and anti-thymocyte globulin. In one embodiment, the immunosuppressive drug is administered with at least one other therapeutic agent. The immunosuppressive drug is administered in a formulation which is compatible with the route of administration and is administered to a subject at a dosage sufficient to achieve the desired therapeutic effect. In another embodiment, the

immunosuppressive drug is administered transiently for a sufficient time to induce tolerance to the cardiovascular stem cells of the invention.

[00298] Pharmaceutical compositions comprising effective amounts of a population of iMNs are also

contemplated by the present invention. These compositions comprise an effective number iMNs, optionally, in combination with a pharmaceutically acceptable carrier, additive or excipient. In certain aspects of the present invention, a population of iMNs can be administered to the subject in need of a transplant in sterile saline. In other aspects of the present invention, a population of iMNs can be administered in Hanks Balanced Salt Solution (HBSS) or Isolyte S, pH 7.4. Other approaches may also be used, including the use of serum free cellular media. In one embodiment, a population of iMNs can be administered in plasma or fetal bovine serum, and DMSO. Systemic administration of a population of iMNs to the subject may be preferred in certain indications, whereas direct administration at the site of or in proximity to the diseased and/or damaged tissue may be preferred in other indications.

[00299] In some embodiments, a population of iMNs can optionally be packaged in a suitable container with written instructions for a desired purpose, such as the reconstitution or thawing (if frozen) of a population of iMNs prior to administration to a subject.

[00300] In one embodiment, an isolated population of iMNs as disclosed herein can be administered with a differentiation agent. In one embodiment, iMNs can be combined with the differentiation agent to administration into the subject. In another embodiment, the cells are administered separately to the subject from the differentiation agent. Optionally, if the cells are administered separately from the differentiation agent, there is a temporal separation in the administration of the iMNs and the differentiation agent. The temporal separation may range from about less than a minute in time, to about hours or days in time. The determination of the optimal timing and order of administration is readily and routinely determined by one of ordinary skill in the art.

[00301] Some embodiments of the present invention may be defined in any of the following numbered paragraphs: 1. A method for transdifferentiation of a first somatic cell into a motor neuron, the method comprising increasing the protein expression of at least three motor-neuron inducing (MN-inducing) factors selected from the group consisting of: Lhx3, Ascll, Brn2, Mytll, l, Hb9, Ngn2 or NeuroDl, wherein the motor neuron exhibits at least two characteristics of an endogenous motor neuron.

2. The method of paragraph 1, wherein the three motor-neuron inducing factors are Lhx2, Ascll and one motor neuron inducing factor selected from the group consisting of: Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroD.

3. The method of any of paragraphs 1 to 3, wherein the three motor-neuron inducing factors are Mytll, Brn2 and one motor neuron inducing factor selected from the group consisting of: Lhx3, Ascl, Isll, Hb9, Ngn2 or NeuroD.

4. The method of any of paragraphs 1 to 3, wherein the three motor-neuron inducing factors do not include Mytll or Brn2.

5. The method of any of paragraphs 1 to 4, wherein the motor neuron inducing factors does not comprise miR-124.

6. The method of any of paragraphs 1 to 5, wherein the motor neuron inducing factors does not comprise isll.

7. The method of any of paragraphs 1 to 5, wherein the somatic cell is a fibroblast cell.

8. The method of any of paragraphs 1 to 6, wherein a characteristic of the motor neuron is expression of at least two motor neuron specific genes selected from the group consisting of: β2- tubulins, Map2, synapsins, synaptophysin, synaptotagmins, NeuroD, Isll, cholineacetyltransferase (ChAT).

9. The method of paragraph 8, wherein the P2 -tubulin is selected from Tubb2a and Tubb2b.

10. The method of paragraph 8, wherein the synapsins is selected from Synl and Syn2.

11. The method of paragraph 8, wherein the synaptotagmins are selected from: Sytl, Syt4, Sytl3, Syt 16.

12. The method of paragraph 8, wherein the ChAT is vesicular ChAT.

13. The method of any of paragraphs 1 to 12, wherein a characteristic of the motor neuron is expression of a decreased level of a fibroblast gene selected from the group of: Snaill, thyl and Fspl, by a statistically significant level as compared to the somatic cell from which the motor neuron was derived.

14. The method of any of paragraphs 1 to 13, wherein a characteristic of the motor neuron is a motor neuron morphology, comprising a cell body with axonal projections which form functional synaptic junctions with muscle cells.

15. The method of any of paragraphs 1 to 14, wherein a characteristic of the motor neuron is an average resting potential of below -50mV.

16. The method of paragraphs 15, wherein the motor neuron has an average resting potential of between -65mV and -50mV. 17. The method of any of paragraphs 1 to 16, wherein a characteristic of the motor neuron is a functional characteristic selected from the group consisting of: ability to fire action potentials, produce an outward current in response to glycine, GABA or kainate, or produce an inward current in response to glutamate.

18. The method of any of paragraphs 1 to 17, wherein the protein expression of a MN-inducing factor is increased by contacting the somatic cell with an agent which increases the expression of the MN-inducing factor.

19. The method of paragraph 18, wherein the agent is selected from the group consisting of: a nucleotide sequence, a protein, an aptamer, a small molecule, a ribosome, a RNAi agent, a peptide - nucleic acid (PNA), or analogues or variants thereof.

20. The method of any of paragraphs 1 to 19, wherein protein expression is increased by introducing at least one nucleic acid sequence encoding a MN-inducing factor protein selected from Lhx3, Ascll, Brn2, Mytll, l, Hb9, Ngn2 or NeuroDl, or encoding a functional fragment thereof, in the somatic cell.

21. The method of any of paragraphs 1 to 20, wherein the protein expression of Lhx3 is increased by introducing a nucleic acid sequence encoding Lhx3 polypeptide comprising SEQ ID NO: 1 or SEQ ID NO: 2 a functional fragment thereof.

22. The method of any of paragraphs 1 to 20, wherein the protein expression of Ascll is increased by introducing a nucleic acid sequence encoding Ascll polypeptide comprising SEQ ID NO: 3 or SEQ ID NO: 4 or a functional fragment thereof.

23. The method of any of paragraphs 1 to 20, wherein the protein expression of Brn2 is increased by introducing a nucleic acid sequence encoding Brn2 polypeptide comprising SEQ ID NO: 5 or SEQ ID NO: 6 or a functional fragment thereof.

24. The method of any of paragraphs 1 to 20, wherein the protein expression of Mytll is increased by introducing a nucleic acid sequence encoding Mytll polypeptide comprising SEQ ID NO: 7 or SEQ ID NO: 8 or a functional fragment thereof.

25. The method of any of paragraphs 1 to 20, wherein the protein expression of Isll is increased by introducing a nucleic acid sequence encoding Isll polypeptide comprising SEQ ID NO: 9 or SEQ ID NO: 10 or a functional fragment thereof.

26. The method of any of paragraphs 1 to 20, wherein the protein expression of Hb9 is increased by introducing a nucleic acid sequence encoding Hb9 polypeptide comprising SEQ ID NO: 11 or SEQ ID NO: 12 or a functional fragment thereof.

27. The method of any of paragraphs 1 to 20, wherein the protein expression of Ngn2 is increased by introducing a nucleic acid sequence encoding Ngn2 polypeptide comprising SEQ ID NO: 13 or SEQ ID NO: 14 or a functional fragment thereof. 28. The method of any of paragraphs 1 to 20, wherein the protein expression of NeuroDl is increased by introducing a nucleic acid sequence encoding NeuroDl polypeptide comprising SEQ ID NO: 15 or SEQ ID NO: 16 or a functional fragment thereof.

29. The method of any of paragraphs 1 to 28, wherein the nucleic acid sequence is in a vector.

30. The method of any of paragraphs 1 to 29, wherein the vector is a viral vector or a non-viral vector.

31. The method of paragraph 30, wherein the viral vector comprises a genome which does not integrate into the somatic cell genome.

32. The method of any of paragraphs 1 to 31 , wherein the somatic cell is in vitro.

33. The method of any of paragraphs 1 to 31, wherein the somatic cell is ex vivo.

34. The method of any of paragraphs 1 to 33, wherein the somatic cell is a mammalian somatic cell.

35. The method of paragraph 34, wherein the mammalian somatic cell is a human somatic cell.

36. The method of any of paragraphs 1 to 35, wherein the somatic cell is obtained from a subject.

37. The method of paragraph 36, wherein the subject is a human subject.

38. The method of paragraph 37, wherein the subject has, or is at risk of developing a motor neuron disease or disorder.

39. The method of paragraph 38, wherein the motor neuron disease or disorder is selected from amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy (SMA) or associated diseases thereof.

40. The method of any of paragraphs 1 to 39, wherein the motor neuron is a motor neuron-like cell.

41. An isolated population of motor neurons obtained from a population of somatic cells by a process of increasing the protein expression of at least three motor-neuron inducing (MN-inducing) factors selected from the group consisting of: Lhx3, Ascll, Brn2, Mytll, l, Hb9, Ngn2 or NeuroDl, or a functional fragment thereof, in a somatic cell.

42. The isolated population of motor neurons of paragraph 41, wherein the motor neuron exhibits at least two characteristics of an endogenous motor neuron.

43. The isolated population of motor neurons of paragraph 41, wherein the somatic cell is a fibroblast.

44. The isolated population of motor neurons of any of paragraphs 41 to 43, produced by the method of any of paragraphs 1 to 40.

45. The isolated population of motor neurons of any of paragraphs 41 to 44, wherein the somatic cell is a mammalian somatic cell.

46. The isolated population of motor neurons of any of paragraphs 41 to 45, wherein the mammalian somatic cell is a human somatic cell.

47. The isolated population of motor neurons of any of paragraphs 41 to 46, wherein the human somatic cell is obtained from a subject at risk or, or having a motor neuron disease or disorder. 48. The isolated population of motor neurons of paragraph 47, wherein the motor neuron disease or disorder is selected from amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy (SMA) or associated diseases thereof.

49. A method for treating a subject with a motor neuron disease or disorder, comprising administering a composition comprising an isolated population of motor neurons according to paragraphs 41 to 48.

50. The method of paragraph 49, wherein the motor neurons are produced from a somatic cell obtained from the same subject as the composition is administered to.

51. The method of paragraph 49, wherein motor neuron disease or disorder is selected from amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy (SMA) or associated diseases thereof.

52. Use of an isolated population of motor neurons according to paragraphs 41 to 48 for administering to a subject in need thereof.

53. An assay comprising an isolated population of motor neurons according to any of paragraphs 41 to 48.

54. The assay of paragraph 53 for use in identifying one or more test agents which promote or inhibit motor neuron survival.

55. The assay of paragraph 53, for use in identifying one or more test agents which promote the direct transdifferentiation of a somatic cell into a motor neuron.

56. A kit comprising at least three of the following agents:

a. a nucleic acid sequence encoding a Lhx3 polypeptide or a functional fragment thereof, b. a nucleic acid sequence encoding a Ascll polypeptide or a functional fragment thereof, c. a nucleic acid sequence encoding a Brn2 polypeptide or a functional fragment thereof, d. a nucleic acid sequence encoding a Mytll polypeptide or a functional fragment thereof, e. a nucleic acid sequence encoding a l polypeptide or a functional fragment thereof, f. a nucleic acid sequence encoding a Hb9 polypeptide or a functional fragment thereof, g. a nucleic acid sequence encoding a Ngn2 polypeptide or a functional fragment thereof, and h. a nucleic acid sequence encoding a NeuroDl polypeptide or a functional fragment thereof.

57. The kit of paragraph 56, further comprising instructions for direct transdifferentiation of a somatic cell into a motor neuron comprising at least two characteristics of an endogenous motor neuron.

58. A composition comprising at least one somatic cell and at least three motor-neuron inducing (MN-inducing) factors selected from the group consisting of: Lhx3, Ascll, Brn2, Mytll, l, Hb9, Ngn2 or NeuroDl, or a functional fragment thereof.

59. The composition of paragraph 58, wherein the somatic cell is a fibroblast cell.

60. The composition of paragraph 58, further comprising a motor neuron exhibiting at least two characteristics of an endogenous motor neuron.

61. A culture comprising a motor neuron and muscle cells.

62. The culture of paragraph 61, wherein the motor neurons are human motor neurons. 63. The culture of any of paragraphs 61 to 62, wherein the motor neurons are produced according to any of paragraphs 1 to 48.

64. The culture of any of paragraphs 61 to 63, wherein the muscle cells are myotubules.

[00302] It is understood that the foregoing detailed description and the following examples are illustrative only and are not to be taken as limitations upon the scope of the invention. Various changes and modifications to the disclosed embodiments, which will be apparent to those of skill in the art, may be made without departing from the spirit and scope of the present invention. Further, all patents, patent applications, and publications identified are expressly incorporated herein by reference for the purpose of describing and disclosing, for example, the methodologies described in such publications that might be used in connection with the present invention. These publications are provided solely for their disclosure prior to the filing date of the present application. Nothing in this regard should be construed as an admission that the inventors are not entitled to antedate such disclosure by virtue of prior invention or for any other reason. All statements as to the date or representation as to the contents of these documents are based on the information available to the applicants and do not constitute any admission as to the correctness of the dates or contents of these documents.

[00303] The following Examples are provided to illustrate the present invention, and should not be

construed as limiting thereof.

EXAMPLES

[00304] The examples presented herein relate to the methods and compositions for producing induced motor neurons (iMNs) from somatic cells, e.g., fibroblasts by increasing the expression of at least three MN-inducing factors selected from Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl, for example by using nucleic acid sequences to encoding the proteins Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl of SEQ ID NO: 1-16 or functional fragments thereof. Throughout this application, various publications are referenced. The disclosures of all of the publications and those references cited within those publications in their entireties are hereby incorporated by reference into this application in order to more fully describe the state of the art to which this invention pertains. The following examples are not intended to limit the scope of the claims to the invention, but are rather intended to be exemplary of certain embodiments. Any variations in the exemplified methods which occur to the skilled artisan are intended to fall within the scope of the present invention.

[00305] METHODS AND MATERIALS

[00306] Molecular Cloning, Isolating Embryonic and Adult Fibroblasts, Viral Transduction, and Cell Culture. Complementary DNAs for the 11 candidate factors were each cloned into the pMXs retroviral expression vector using Gateway technology (Invitrogen). H 9.vGFP-transgenic mice (Jackson Laboratories) were mated with ICR mice (Taconic) and MEFs were harvested from Hb9: :GFP E12.5 embryos under a dissection microscope (Leica). TTFs were isolated from H 9.vGFPtransgenic adult mice as previously described (Vierbuchen et al., 2010). The fibroblasts were passaged at least once before being used for experiments. HEFs were isolated from human ESCs by culturing them in DMEM + 20% fetal bovine serum without bFGF for at least three passages.

[00307] Retroviral transduction was performed as described (Ichida et al., 2009). Glial cells isolated from P2 ICR mouse pups were added to infected fibroblasts two days after transduction. The next day, medium was switched either to mouse motor neuron medium containing F-12 (Invitrogen), 5% horse serum, N2 and B27 supplements, glutamax and penicillin/streptomycin, or to N3 medium (Vierbuchen et al., 2010). Both media were supplemented with GDNF, BDNF and CNTF, all at 10 ng/ml. Efficiency of iMN generation was estimated by counting the number of Hb9::GFP+ cells with neuronal morphologies using a fluorescence microscope (Nikon).

[00308] Obtaining ESC-Derived and Embryonic Motor Neurons, FACS, Microarray Analysis, and qPCR.

Motor neurons were derived from Hb9::GFP mouse ESCs and isolated by FACS using standard protocol (Di Giorgio et al., 2007). Embryonic motor neurons were harvested from Hb9::GFP E13.5 embryos. Briefly, whole spinal cords were washed in F-12 (Invitrogen) and incubated in 10 ml of 0.025% trypsin with DNase for 45 minutes with gentle agitation every 15 minutes. Media was added to the dissociated spinal cords and the cells were triturated, spun down at 1 ,000 rpm for 5 minute and resuspended in DMEM/F-12 with glutamax and penicillin/streptomycin. FACS was performed in the same way as with ESC-derived motor neurons. Total RNA isolation, RNA amplification and microarray analysis were performed as described previously (Ichida et al., 2009). qPCR was performed using iScript cDNA synthesis, SYBR green qPCR supermix (Bio-rad), and the primers in Table 2.

[00309] Table 2: RT-Primer sequences:

(SEQ ID NO: 45) (SEQ ID NO: 46)

Viral LTR N/A TTTGTACAAGAAAGCTGGGT

(SEQ ID NO: 47)

[00310] Immunocytochemistry. Antibody staining was performed as previously described (Ichida et al., 2009). The following primary antibodies were used: mouse anti-Hb9 (DSHB, 1 :50), mouse anti-Islet (DSHB, 1 : 100); mouse anti-TuJl (Covance, 1:500); rabbit anti-vChAT (Sigma, 1 :1000); rabbit anti- synapsin I (Millipore, 1:500); goat anti-ChxlO (Santa Cruz, 1 :200); and rabbit anti-tyrosine hydroxylase (ThermoScientific, 1:300).

[00311] Electrophysiology. Whole-cell voltage-clamp and current-clamp recordings were made using a Multiclamp 700B (Molecular Devices) at room temperature (21-23°C). Data were digitized with a Digidata 1440A A/D interface and recorded using pCLAMP 10 software (Molecular Devices). Data were lowpass filtered at 2 kHz and sampled at 20 kHz (1kHz and 2 kHz, respectively, for transmitter application). Patch pipettes were pulled from borosilicate glass capillaries on a Sutter Instruments P-97 puller and had resistances of 2-4 ΜΩ. The pipette capacitance was reduced by wrapping the shank with Parafilm and compensated for using the amplifier circuitry. Series resistance was typically 5-10 ΜΩ, always less than 15 ΜΩ, and compensated by at least 80%. Leak currents were typically less than 200 pA with mean input resistance 675 ΜΩ and mean resting potential -49 mV. For study of voltage-gated conductances, linear leakage currents were digitally subtracted using a P/4 protocol and voltage was stepped from a holding potential of -80 mV to test potentials from -80 to 30 mV in 10 mV increments. Intracellular solutions were potassium-based solution and contained KC1, 150; MgC12, 2; HEPES, 10; pH 7.4 used for earlier experiments and KC1, 135; MgC12, 2; HEPES, 10; MgATP, 4; NaGTP, 0.3; Na2PhosCr, 10; EGTA, 1 ; pH 7.4 used for later experiments with no obvious difference in sodium and potassiumcurrents. The extracellular was sodium-based and contained NaCl, 135; KC1, 5; CaC12, 2; MgC12, 1 ; glucose, 10; HEPES, 10; pH 7.4). Based on the chloride Nernst potential of -2 mV, inward currents were expected following GABA and glycine treatment (Puia et al., 1990). Transmitters were not washed out, explaining the delayed current decay.

[00312] C2C12 Muscle Co-Culture. C2C12 myoblasts were expanded in DMEM with 20% fetal bovine serum and penicillin/streptomycin. When the culture reached 100% confluency, the serum content was reduced to 5% to induce differentiation. Flow-purified iMNs or iNs were added to the myotubes after 7- 14 days and the medium switched to either mouse motor neuron or N3 media. The cocultures were monitored for myotube contractions under the microscope with lOx or 20x objectives. To stop contractions, a solution of tubocurarine hydrochloride was added to a final concentration of between 50 nM and 50 μΜ. Twitching myotubes were filmed using Nikon ACT-2U Imaging Software (Excel Technologies) and contraction frequencies determined.

[00313] iMN-Chick Myotube Co-Cultures and Immunocytochemistry. Myoblasts were isolated from the epaxial (longissimus) muscles of E10 White Leghorn chick embryos and plated in 24- well plates at a density of 100,000 cells/well. Cultures were maintained at 370C in F10 media (Gibco) supplemented with 0.44 mg/ml calcium chloride, 10% horse serum, 5% chicken serum and 2% penicillin:streptomycin. iMNs were added to the myotubes 5 days later in Neurobasal media (Gibco) supplemented with B27 (Gibco), 1% Lglutamine and 1% penicillin:streptomycin. Co-cultures were supplemented with lOng/mL CNTF and GDNF every two days for the first week following the addition of the iMNs. Co-cultures were maintained for 3 weeks when they were prepared for immunocytochemistry. Antibody staining was performed as previously described (Soundararajan et al., 2006). A rabbit anti-GFP (Chemicon, 1 :2000) primary antibody was used to visualize the iMNs and rhodamine -conjugated oc-bungarotoxin (Invitrogen, 1 :500) was used to visualize the AChRs. Images were acquired on a laser scanning-confocal microscope (Zeiss LSM 510). Orthogonal images were rendered and edited with LSM imaging software (Zeiss) and further contrast and brightness adjustments were performed on Photoshop version 7.0.

[00314] In Ovo Transplantation of ESC-derived motor neurons and iMNs. In ovo transplantations and immunohistochemistry were performed as previously describedl2. Briefly, E2.5 chick embryos were exposed; the vitelline membrane and amnion were cut to allow surgical access to the neural tube. An incision of 1-1.5 somites in length was made along the midline of the neural tube at the rostral extent of the developing hind limb bud (T7-L1) using a flame-sterilized tungsten needle (0.077 mm wire, World Precision Instruments). For control ESC-derived motor neuron transplantations, H 9.vGFP-transgenic mouse ESCs were differentiated into motor neurons as described previously (Soundararajan et al., 2006; Wichterle et al., 2002). A single embryoid body containing approximately 150-200 differentiated Hb9: :GFP+ motor neurons was transplanted into the ventral lumen of the neural tube of E2.5 chick embryos as described previously (Soundararajan et al., 2006). For iMN transplantations, a sphere of iMNs mixed with non-transgenic, ESC-derived motor neurons containing approximately 200 cells was transplanted into the ventral lumen of the neural tube of E2.5 chick embryos. For all transplantations, the chick embryos were harvested five days later, fixed in 4% paraformaldehyde/PBS, cut on a cryostat and then processed for immunohistochemistry. The following primary antibodies were used: rabbit anti-GFP (Chemicon, 1: 1000) and mouse anti- Tuj l (Covance, 1: 1000). Images were captured with a digital camera (C4742; Hamamatsu Photonics, Hamamatsu, Japan) in conjunction with digital imaging acquisition software (IPLab; Version 4.0; BD Biosciences, Rockville, MD, USA).

[00315] Glia-Neuron Co-Culture for Disease Modeling. SOD1G93A transgenic mice (Jackson

Laboratories) were mated with ICR mice. Glial preps were derived from transgenic P2 pups and their littermates. 3 weeks later, confluent flasks of glial cells were passaged 1:2 onto 6-well plates and iMNs were plated on top. The co-cultures were kept in mouse motor neuron medium with neurotrophic factors and the media changed every other day for the duration of the experiment.

[00316] Nestin::CreER Lineage Tracing. MEFs were isolated from E13.5 embryos that were transgenic for Nestiny.CreER, LOX-STOPLOX H2B-mCherry, and Hb9::GW. To generate iPSCs, the MEFs were transduced with retroviruses (pMXs vector) encoding Oct4, Sox2, and Klf4. Cells were cultured in mES media containing 13% Knockout Serum Replacement and colonies were picked, expanded, and verified by Nanog immunostaining. For the positive control, iPSCs were differentiated into motor neurons using retinoic acid and Sonic Hedgehog (Wichterle et al., 2002) in the presence or absence of 2 μΜ 4-OHT. iMNs were also created in the presence or absence of 2 μΜ 4-OHT.

EXAMPLE 1

[00317] In order to determine whether transcription factors can bestow a precise neural subtype identity, we sought factors that could reprogram fibroblasts into spinal motor neurons. Here, the inventors demonstrate induction of motor neurons based on their significant translational utility and because the developmental origins and functional properties of this neural subtype are among the most well understood.

[00318] The inventors demonstrate that when mouse fibroblasts express factors previously found to induce reprogramming toward a generic neuronal phenotype (Vierbuchen et al., 2010), they also respond to components of the transcription factor network that act in the embryo to confer a motor neuron identity on committed neural progenitors. Thus, the inventors demonstrated that forced expression of these transcription factors converted mouse fibroblasts into induced motor neurons (iMNs).

[00319] Importantly, the inventors demonstrated that the resulting iMNs had a gene expression program, electrophysiological activity, synaptic functionality, in vivo engraftment capacity and sensitivity to disease stimuli that are all indicative of a motor neuron identity. The inventors also demonstrate that the converting fibroblasts do not transition through a proliferative neural progenitor state before becoming motor neurons, indicating they are formed in a manner that is distinct from embryonic development. Finally, the inventors demonstrate that this same approach can convert human fibroblasts into motor neurons.

EXAMPLE 2

[00320] 11 Factors Convert Fibroblasts into HZ>9::GFP+ Cells with Neuronal Morphologies.

[00321] The inventors assessed if transcription factors known to instruct motor neuron formation during development might also facilitate the conversion of other cell types into motor neurons. The inventors used the literature to select eight candidate transcription factors that participate in varied stages of motor neuron specification (Jessell, 2000). In order to potentially aid the transition toward a neuronal phenotype, the inventors supplemented the motor neuron specification factors with three factors that convert fibroblasts into induced neurons (iNs) of a generic character (Ascll, Brn2 and Mytll)

(Vierbuchen et al., 2010) (Figure 1A).

[00322] For reprogramming studies, mouse embryonic fibroblasts (MEFs) were harvested from

Hb9: :GFP mouse embryos at day El 2.5, allowing spinal motor neuron conversion to be monitored. Prior to use, cultures of MEFs were carefully screened for the absence of any contaminating GFP+ cells. First, the action of the three iN factors alone was assessed to determine if they could generate

Hb9: :GFP+ cells by transducing MEFs with retroviral vectors encoding Ascll, Brn2 and Mytll (Figure 1A). Although cells with a neuronal morphology were observed, as previously reported (Vierbuchen et al., 2010), no H&9::GFP+ cells emerged, even after 35 days (Figure 8A). This demonstrates that while iN factors can generate neurons, the iN factors alone do not generate motor neurons, consistent with the report that cholinergic neurons were not generated by these factors (Vierbuchen et al., 2010).

[00323] The inventors next assessed whether the selected eight motor neuron (MN) specification factors could induce motor neurons in the absence of the three iN factors. Based on titering with a control virus encoding GFP, the inventors determined that each factor was expressed in >95% of the fibroblasts. Encouragingly, a small number of Hb9::GFP+ cells were detected at 35 days post-transduction;

however, they did not possess a normal neuronal morphology (Figure 8A). The inventors therefore next asked whether the two sets of factors, iN factors and motor neuron specification factors, together could synergize to produce motor neurons. Indeed, when the aggregate set of 11 factors was transduced into fibroblasts, a significant number of Hb9::GFP+ cells emerged, which elaborated complex processes and all of which expressed a neuronal form of tubulin (n=50) (Figure IB). These cells were preliminarily designated these Hb9::GFP+ cells, induced motor neurons (iMNs).

EXAMPLE 3

[00324] iMNs Are Efficiently Induced by 7 Factors. To determine which of the 11 factors were

necessary for generating iMNs, each gene was omitted one at a time (Figure 8B). Excluding either Lhx3 or Ascll eliminated iMN formation. However, reprogramming efficiency was either only slightly reduced or unchanged when each of the remaining factors were removed (Figure 8B). Interestingly, ectopic expression of Hb9 was not required for iMN formation (Figure 8B), demonstrating that, at least in that case, exogenous Hb9 was not simply transactivating its own promoter. Similarly, Isll/2 expression was detected by immunostaining in iMNs (80.6%, n=36), even when the Isll retrovirus was omitted from the transduction (Figures 1C-D and Figure 8B).

[00325] Although Lhx3 and Ascll seemed necessary for reprogramming, they were not sufficient to induce motor neuron formation (Figure 8C). However, when Lhx3 was combined with the three iN factors (Ascll, Brn2 and Mytll), a modest number of Hb9::GFP+ cells were detected (Figure IE). Because these four factors could not efficiently induce motor neuron formation, the inventors next individually added each of the other factors back to this smaller set (Figure IE). The inventors discovered that either Isll or Hb9 were capable of increasing the efficiency of iMN induction, which was further enhanced when Ngn2 was added to the other 6 factors (Figure IF). Indeed, the efficiency of motor neuron induction with these 7 factors (Ascll, Brn2, Mytll, Lhx3, Hb9, Isll and Ngn2) surprisingly surpassed the activity of the 11 as a whole and, depending on the culture conditions used, reached between 5% and 10% of the number of MEFs transduced (Figure IF and Figure 8E). Surprisingly, adding any one of the remaining factors, which were previously all known to function in earlier stages of motor neuron specification (Lee et al., 2005), dramatically decreased the efficiency of reprogramming by the 7 factors (Figure 8D). [00326] The inventors next assessed if the apparently homogeneous MEF cultures which lacked

H&9::GFP+ cells, could be contaminated with rare embryonic neuronal progenitors that might be more responsive to reprogramming. To rule out the possibility that iMNs originated from such progenitors, fibroblasts from the tails of adult Hb9: :GFP mice were prepared and transduced with the optimal set of 7 factors. Again, GFP+ cells with neuronal morphologies were detected (Figure 1G), demonstrating that the ability to respond to the 7 iMN factors was not restricted to cells of an embryonic origin.

EXAMPLE 4

[00327] iMNs Possess a Motor Neuron Gene Expression Signature. To assess whether iMNs had the known characteristics of cultured embryonic motor neurons, the inventors carefully examined the phenotype of iMNs made with 10 factors {Isll omitted). The inventors demonstrated that iMNs were comparable in cell body size and projection length to both E13.5 embryo and ESC-derived motor neuron controls (Figure 9A). To determine how similar overall transcription in iMNs was to control motor neurons, the three motor neuron types were isolated by fluorescence-activated cell sorting (FACS) and assessed by transcriptional profiling (Figure 2A-2D). For these analyses, RNAs isolated from MEFs and ESCs were used as negative controls. On hierarchical clustering of the data, iMNs grouped closely to embryonic motor neurons, as did ESC-derived motor neurons (Figure 2A). In contrast, iMNs were very distinct from the initial MEF population. Thus, the inventors demonstrate that transduction of MEFs with these transcription factors results in a global shift towards a motor neuron transcriptional program.

[00328] On examination of the transcription of specific neuronal genes, the inventors demonstrated that iMNs and control motor neurons were very similar. Relative to either MEFs or ESCs, iMNs and both types of control motor neurons expressed elevated levels of 2-tubulins (Tubb2a and Tubb2b) and Map2 (Figure 2B-D and Figure 9B), as well as synaptic components such as synapsins (Synl and Syn2), synaptophysin (Syp) and synaptotagmins (Sytl, Syt4, Sytl3 and Syt 16) (Figure 2B-D and Figure 9C). iMNs also expressed known motor neuron transcription factors that were not provided exogenously (NeuroD and Isll) (Figure 2C-D and Figure 9D), as well as the gene encoding the enzyme

cholineacetyltransferase (ChAT) (Figure 2C-D and Figure 9E). In contrast, iMNs had downregulated the fibroblast program as exemplified by reduced transcription of Snail, Thyl and Fspl (Figure 2D and Figure 9F).

[00329] Immunostaining confirmed that the iMNs expressed Map2 (100%, n=120) (Figure 3A),

synapsin (Figure 3B), and vesicular ChAT (97.6%, n=124) (Figure 3C), demonstrating that they had indeed activated the enzymatic pathways for producing acetylcholine (ACh), the neurotransmitter released by motor neurons, and demonstrating that iMNs should be capable of forming functional synapses. In contrast, the vast majority of iMNs did not express tyrosine hydroxylase (3%, n=150) (Figure 9G), demonstrating that they were not of a mixed neuronal character. In order to determine if the iMNs truly adopted a new cellular identity through transdifferentiation, qRT-PCR analysis was performed to assess if they established an endogenous program of motor neuron gene expression (Table 2). As expected for a somatic cell type such as the motor neuron, the retroviral transgenes used for reprogramming were not silenced in the iMNs (Figure 9H), leaving it unclear as to whether the endogenous loci of these motor neuron genes had been activated. When the inventors quantified the endogenous mRNA levels of the motor neuron-specific genes used for conversion, they discovered that all 7 transcription factors were expressed at levels similar to those in ESC-derived motor neurons (Figure 2E). Furthermore, immunostaining revealed that iMNs created without exogenous Hb9 still activated expression of this important transcription factor from the endogenous locus (87.9%, n=149) (Figure 3D).Together, the inventors herein demonstrate that the iMNs produced had established a transcriptional program characteristic of motor neurons.

EXAMPLE 5

[00330] iMNs Possess the Electrophysiological Characteristics of Motor Neurons. In order to

determine if MEF- and tail tip fibroblast-derived iMNs possessed the electrophysiological properties of motor neurons, the inventors performed whole-cell patch clamp recordings. The average resting membrane potential for iMNs was -49.5 mV (SEM 5.6, n=6), which was similar to that for control ESC- derived motor neurons (-50.5 mV, SEM 3.5, n=13). Depolarizing voltage steps in voltage clamp elicited fast inward currents followed by slow outward currents, consistent with the opening of voltage-activated sodium and potassium channels, respectively (Figures 4A-B and Figure 10A). The inward current was blocked by addition of 500 nM tetrodotoxin (TTX), a potent antagonist of TTX-sensitive voltage- activated sodium channels (Figure 4C). A defining feature of a neuron is its ability to fire action potentials. In current clamp experiments with iMNs, depolarizing current steps produced single or multiple action potentials (90%, n=10), with overshoot, after-hyperpolarizations and a firing frequency similar to that reported for ESC-derived motor neurons and rat embryonic motor neurons (Alessandri- Haber et al., 1999) (Figures 4D-E and Figure 10B).

[00331] The inventors next assessed whether iMNs express functional receptors for the excitatory and inhibitory neurotransmitters that normally act on motor neurons. As might be expected given the known receptor subunit transitions associated with development of immature neurons to a fully differentiated state, certain agonists yielded responses in some but not all neurons. Glycine and GAB A are the major inhibitory neurotransmitters, and their ionotropic activity is mediated by opening chloride channels. Addition of 100 μΜ glycine (44.4%, n=9, Figure 4F) or GABA (72.7%, n=l l, Figure 4G, and Figure IOC) elicited inward currents when cells were held at -80 mV. We also evaluated the response of iMNs to fast excitatory glutamatergic neurotransmitters and observed a strong response to the receptor agonist kainate (80%, n=15 cells, Figure 4H, and Figure 10D).

[00332] Consistent with the physiological analyses, and similar to previously reported control embryonic motor neurons and motor neuron populations (Cui et al., 2006), the iMNs transcribed the genes encoding a and β subunits of voltage-gated sodium channels (Figure 2C-D and Figure 10E), as well as members of the Shaker-, Shaw-, and Eag-related, inwardly rectifying, and calcium-activated families of potassium channels (Figure 2C-D and Figure 10G). In addition, iMNs transcribed genes encoding the receptor components required for responding to the neurotransmitter glutamate (Figure 2C-D and Figure 10F). Thus the inventors, using physiological and gene expression analyses, clearly demonstrate that iMNs are excitable, generate action potentials and respond to both inhibitory and excitatory neurotransmitters in a manner characteristic of both ESC-derived and embryonic motor neurons.

EXAMPLE 6

[00333] iMNs Form Functional Synapses With Muscle. The inventors initial analysis demonstrated that iMNs have many of the phenotypic and electrophysiological properties of bona fide motor neurons. However, the defining functional characteristic of the spinal motor neuron is its ability to synapse with muscle and, through the release of acetylcholine (ACh), stimulate muscle contraction. To test whether iMNs could form functional neuromuscular junctions (NMJs), the inventors co-cultured FACS-purified iMNs with myotubes derived from the C2C12 muscle cell line. The inventors demonstrate that iMNs could establish themselves in these muscle cultures and sent projections along the length of the myotubes (Figure 10H).

[00334] Strikingly, the inventors demonstrated that several days following the addition of purified iMNs, C2C12 myotubes began to undergo regular and rhythmic contraction (Figure 41). Regular contractions were not seen at this time point in myotubes that were cultured alone or with generic iNs (Table 3).

[00335] To directly test whether the regular contractions of mytotubes were due to synaptic stimulation of ACh receptors, the inventors quantified the frequency of myotube contraction and then added curare to the culture medium. As curare selectively and competitively antagonizes nicotinic ACh receptors, its addition should only inhibit muscle contractions that result from stimulation of such receptors (Figure 41 and data not shown). Shortly after the addition of curare, the inventors detected a precipitous and sustained decline in the frequency of myotube contraction, demonstrating that the contractions were indeed dependent on the stimulation of ACh receptors. In order to directly visualize NMJ formation in iMN cultures, iMNs were co-cultured with primary chick myotubes (Figure 4J and Figures 10I-10L). After one week of co-culture, the inventors determined that many Hb9::GFP+ iMNs survived even following withdrawal of neurotrophic support, demonstrating that they had formed synapses with the muscle. Three weeks after co-culture had been initiated, staining with a-bungarotoxin (a-BTX) revealed ACh receptor clustering on the myofibers (Figures 4J and Figure 10I-K). As occurs in ESC-derived motoneuron/chick myotube cocultures (Miles et al., 2004; Soundararajan et al., 2007), ACh receptors clustered preferentially near the iMN axons, although the clustering was not always clearly opposed to Hb9::GFP+ axons. This phenomenon is similar to what occurs during chick (Dahm and Landmesser, 1988) and mouse (Lupa and Hall, 1989) neuromuscular development where receptor clustering first appears near the innervating motor axons, but not always in direct contact. Imaging in the x-z and y-z orthogonal planes verified that ACh receptors clustered near iMN axons superimposed with the

Hb9::GFP+ axons (Figure 10L). These results demonstrate that the iMNs signal to the post-synaptic muscle fiber to induce appropriate receptor clustering which is necessary for neuromuscular transmission. Together, the inventors have determined that functional iMNs can be produced from fibroblasts which make functional synaptic junctions with muscle.

[00336] Table 3: iMNs induce contraction of C2C12 myotubules. F ACS -purified iMNs and ins were plated on top of C2C12 myotubules. At day 10 after the start of co-culture, contraction was detected in myotubules cultured with iMNs. Myotubules cultured alone or with iNs did not exhibit contractions at this time point.

EXAMPLE 7

[00337] iMNs Integrate into the Developing Chick Spinal Cord. Transplantation of motor neurons into the developing chick spinal cord provides a rigorous test of their ability to survive in vivo, migrate to appropriate engraftment sites in the ventral region of the spinal cord, and to properly respond to axon guidance cues to send their axonal projections out of the spinal cord through the ventral root (Peljto et al., 2011 ; Soundararajan et al., 2006; Wichterle et al., 2002). In order to test the ability of iMNs to survive and function in vivo, FACS-purified iMNs or control ESC-derived motor neurons were transplanted into the neural tube of stage 17 chick embryos at 12-16 days post-transduction (Figure 5A). Although the injection of the iMNs along the dorsal-ventral axis was not precisely controlled, the inventors determined that Hb9::GFP+ iMNs engrafted in the ventral horn of the spinal cord in the location where endogenous motor neurons reside at stage 31 (Figure 5B). Like transplanted ESC-derived motor neurons (Soundararajan et al., 2006; Wichterle et al., 2002), the Hb9::GFP+ cells maintained Tuj l expression and exhibited extensive dendritic arbors (Figure 5B). In addition, the inventors assessed whether iMNs project their axons out of the CNS. Endogenous and transplanted ESC-derived motor neurons send axonal projections out of the spinal cord through the ventral root towards musculature (Figure 11) (Soundararajan et al., 2010; Wichterle et al., 2002). When Hb9::GFP ESCs are subjected to directed differentiation toward motor neurons, the resulting EBs contain both GFP+ motor neurons and distinct, non-motor neuronal subtypes that do not express GFP. In contrast to GFP+ motor neurons, GFP- non-motor neuron subtypes present within the same transplants extend extensive processes whose projections remain restricted to the developing spinal cord and do not exit through the ventral root (Soundararajan et al., 2010). Therefore, the chick transplantation assay can be used to measure motor neuron-specific axonal pathfinding. Indeed, after transplantation, the inventors determined Hb9::GFP+ iMNs in the ventral horn of the spinal cord, and in 80% (n=5) of these cases, axons of Hb9::GFF+ iMNs were detected to be projecting out of the spinal cord through the ventral root towards the musculature (Figure 5B). Thus, Hb9::GFF+ iMNs in vivo engraftment capacity was similar to that for ESC-derived H&9::GFP+ motor neurons (Figure 11). Thus the inventors have demonstrated that iMNs are able to engraft, migrate to appropriate sites of integration, and correctly respond to guidance cues in vivo, projecting their axons out of the CNS.

EXAMPLE 8

[00338] iMNs Are Sensitive to Disease Stimuli. ALS is an invariably fatal neurological condition

whose hallmark is the selective and relentless degeneration of motor neurons. The inventors assessed if iMNs fully phenocopied bona fide, motor neurons by assessing if they are also sensitive to degenerative stimuli thought to contribute to ALS. To assess this, iMNs were co-cultured with glial cells from the SOD1G93A mouse model of ALS. The inventors demonstrate, as was previously reported, that both embryonic and ESC-derived motor neurons are selectively sensitive to the toxic effect of mutant glia, while other neural cell types, such as spinal interneurons, are relatively unaffected (Di Giorgio et al., 2007) (Nagai et al., 2007). iMNs were co-cultured with either wild-type or mutant SOD1G93A glia and the number of Hb9::GFP+ iMNs quantified 10 days later. It was determined that iMNs were indeed bona fide motor neurons, as there was a sharp reduction in the number of iMNs co-cultured with mutant glia relative to those cultured with wild-type glia (Figures 5C-D), and the effect was similar in magnitude to its reported effect on ESC-derived motor neurons (Di Giorgio et al., 2007) (Nagai et al., 2007).

[00339] Currently, it is unclear whether there are cell-autonomous mechanisms of motor neuron

degeneration induced by mutant SOD1 that can lead to overt differences in motor neuron survival in vitro. To assess whether iMNs could be used to answer this question, the inventors assessed if there is a survival difference between wild-type and SOD1G93A iMNs in culture with wild-type glia. MEFs were prepared from mouse embryos that overexpress the SOD1G93A transgene as well as harbor the Hb9: :GFP reporter, and transdifferentiated them into Hb9: :GFP+ iMNs alongside MEFs which only contain the Hb9: :GFP reporter. FACS-purified Hb9: :GFF+ iMNs of both genotypes were performed in parallel and plated the same number of cells for each on wild-type glia. After 4 days in culture, the inventors detected impaired survival of SOD1G93A iMNs relative to control iMNs (Figure 5E), demonstrating a cell-autonomous disease phenotype. Thus, the inventors have demonstrated that iMNs are useful for studying both cell autonomous and non-autonomous contributors to motor neuron degeneration in ALS.

[00340] Because there is significant interest in the identity of factors and pathways that modulate

neuronal survival in the context of neurodegenerative diseases, the inventors also tested whether iMNs were similar to motor neurons in their sensitivity to growth factor withdrawal. Indeed, when the neurotrophic factors GDNF, BDNF and CNTF were all withdrawn from the medium, iMNs were lost more rapidly (Figure 5F). Thus, iMNs were determined share a neurotrophic support requirement similar to embryonic motor neurons, and the inventors demonstrate that iMNs could serve as a suitable substrate for in vitro studies of motor neuron function, disease and injury. EXAMPLE 9

[00341] Fibroblasts Do Not Transit Through a Neural Progenitor State Before Becoming iMNs.

The process by which the initial fibroblasts undergo conversion into another cell type in defined factor reprograrnming and transdifferentiation experiments remains poorly understood. In particular, it is currently unknown if the somatic cells reprogram through the same developmental intermediates that are found in the developing embryo, for example, by first dedifferentiating and then re-differentiating through a neural progenitor state into a neuron, or if they instead convert more "directly". To address this question, the inventors used a lineage tracing approach to assess if during the course of

reprograrnming, a gene commonly used to identify neuronal progenitors ever became expressed. Motor neuron progenitor cells are highly proliferative in culture (Frederiksen and McKay, 1988; Jessell, 2000). To determine whether iMNs transited through a highly proliferative intermediate during the

reprograrnming process, the inventors quantified the timing of cell division in the reprograrnming cultures using 48-hour pulses of BrdU. Following transduction, the inventors demonstrated that the cells incorporated decreasing amounts of BrdU at each subsequent time point and did not incorporate detectable levels of Brdu after 4 days post-transduction (Figure 6A). Consistent with a previous report (Vierbuchen et al., 2010), these results demonstrate that the transduced cells quickly become postmitotic. Since 10% of the fibroblasts eventually become iMNs and because GFP+ iMNs do not begin to appear in culture until day 5 and the majority arise between 7 and 14 days in culture these results demonstrate that the iMNs are not being produced from highly proliferative neuronal progrenitors.

[00342] To more definitively test if the fibroblasts become motor neuron progenitors before

differentiating into iMNs, the inventors repeated the induction of a motor neuron identity using transgenic fibroblasts with a Nestin::CreER (Burns et al., 2007); lox-stop-lox-H2B-mCherry (Abe et al.); Hb9::GFP genotype (Figure 6B). Because Nestin is a well-known marker of neural progenitor cells in the mammalian CNS (Messam et al., 2002), the inventors assessed if the fibroblasts transited through a progenitor state before becoming motor neurons by assessing if the resulting iMNs activate expression of Nestin: :CreER, recombine the reporter gene and thus express both mCherry and Hb9::GEP.

[00343] First, as a positive control for this experiment, iPSCs were generated from the fibroblasts, and differentiated into motor neurons using retinoic acid and sonic hedgehog (Wichterle et al., 2002). As this directed differentiation protocol mimics development, the inventors expected the resulting motor neurons to originate from Nestin+ precursors. When the differentiation was performed without 4- hydroxytamoxifen (4-ΟΗΤ), none of the resulting Hb9::GEP+ motor neurons expressed mCherry (Figure 6C). However, when 4-OHT was added to the differentiation, 3% of the motor neurons co- expressed mCherry (n > 10,000) (Figure 6C), verifying that the Nestin .CreER reporter successfully identified motor neurons that transited through a Nestin+ progenitor state. In contrast, when the 7 factor- transduced MEF cultures were treated with 4-OHT both before and during transdifferentiation, none of the resulting iMNs expressed mCherry (n > 5,000) (Figure 6D). These results demonstrate that fibroblasts do not become iMNs by transiting through a motor neuron progenitor cell state and further rule out the possibility that many of the iMNs are derived from contaminating neural progenitor cells in the MEF cultures.

EXAMPLE 10

[00344] Human iMNs Can Be Generated by 8 Transcription Factors. The inventors next assessed whether the same, or a similar set of factors could be used to generate human iMNs from fibroblasts. To this end, human embryonic fibroblasts (HEFs) were derived from a human ESC line harboring the Hb9::GFP transgene (Di Giorgio et al., 2008). The HEFs were then transduced with viruses containing the 7 iMN factors identified in the mouse system as well as NEUROD1, a pro-neural gene reported to enhance the conversion efficiency of human fibroblasts into iNs (Pang et al., 2011). 30 days after transduction, Hb9::GFP+ cells were detected with highly neuronal morphologies in the culture of 8 factor-transduced HEFs (Figures 7A-B), whereas untransduced HEFs never spontaneously expressed the transgene under the same conditions (Figure 7B). These putative human iMNs expressed vesicular ChAT (Figure 7C), demonstrating that they were indeed cholinergic in nature. In order to assess the functionality of human iMNs made with 8 factors, whole -cell patch clamp recording was used to look at their electrophysiological properties. Similar to their mouse counterparts, human iMNs expressed functional voltage-gated sodium and potassium channels (Figure 7D) and were able to fire action potentials (Figure 7E) when depolarized. Importantly, human iMNs responded appropriately to the addition of 100 μΜ kainate (Figure 7F) and ΙΟΟμΜ GABA (Figure 7G), demonstrating their ability to receive and respond to the major excitatory and inhibitory inputs, respectively, that govern spinal motor neuron activity. Therefore, the inventors demonstrate the generation of functional human iMNs from human fibroblasts by transdifferentiation.

EXAMPLE 11

[00345] The inventors have demonstrated that a small set of transcription factors can convert embryonic and adult fibroblasts into functional motor neurons. The iMNs expressed pan-neuronal and motor neuron specific markers, as well as the receptors and channels that generate excitable membranes sensitive to transmitters, allowing them both to fire action potentials and receive synaptic input.

[00346] These cholinergic iMNs also possessed the defining hallmark of motor neurons: the ability to synapse with muscle and to induce its contraction. Most importantly, iMNs are able to contribute to the developing CNS in vivo, migrating appropriately to the ventral horn and sending out axonal projections through the ventral root. The inventors also demonstrated that the iMNs are sensitive to a degenerative ALS stimulus that selectively affects motor neurons. Thus we provide several lines of evidence that iMNs are functional motor neurons with consequent utility for the study of motor neuron physiology and disease susceptibility.

[00347] It is also possible that other motor neuron inducing (MN-inducing) factors can be used, or that varying the cocktail of genetic factors might further enhance the frequency or even accuracy of conversion, which can be determined by routine screening experiments by someone of ordinary skill in the art. Thus, a smaller number of the MN-inducing factors as identified here, or a group of similar factors, can be capable of converting adult human fibroblasts into motor neurons. Such a reprogramming approach has significant advantages of greatly facilitate the production of patient-specific motor neurons for therapeutic uses in regenerative medicine as well as for disease-related studies.

[00348] Additionally, the inventors have demonstrated a efficient conversion of fibroblasts to motor neurons via trandifferentiation, which occurs extremely efficiently given that the cells do not transit through a neural progenitor state. Surprisingly, under certain conditions, as many as one H&9::GFP+ iMN was made from every 10 MEFs. This efficiency was substantially higher than previously reported iPSC reprogramming (Takahashi and Yamanaka, 2006). The inventors demonstrate herein that the massive changes in gene expression induced during defined-factor reprogramming can be executed efficiently even though they do not mimic embryonic development precisely.

[00349] The practice of the present invention will employ, unless otherwise indicated, conventional

techniques of mouse genetics, developmental biology, cell biology, cell culture, molecular biology, transgenic biology, microbiology, recombinant DNA, and immunology, which are within the skill of the art. Such techniques are described in the literature. See, for example, Current Protocols in Cell Biology, ed. by Bonifacino, Dasso, Lippincott-Schwartz, Harford, and Yamada, John Wiley and Sons, Inc., New York, 1999; Manipulating the Mouse Embryos, A Laboratory Manual, 3^rd Ed., by Hogan et al., Cold Spring Contain Laboratory Press, Cold Spring Contain, New York, 2003; Gene Targeting: A Practical Approach, IRL Press at Oxford University Press, Oxford, 1993; and Gene Targeting Protocols, Human Press, Totowa, New Jersey, 2000. All patents, patent applications and references cited herein are incorporated in their entirety by reference.

[00350] The present invention is well adapted to carry out the objects and obtain the ends and advantages mentioned, as well as those inherent therein. The methods, systems and kits are representative of certain embodiments, are exemplary, and are not intended as limitations on the scope of the invention.

Modifications therein and other uses are also contemplated herein. These modifications are encompassed within the spirit of the invention and are defined by the scope of the claims. Varying substitutions and modifications may be made to the invention disclosed herein without departing from the scope and spirit of the invention.

[00351] The articles "a" and "an" as used herein in the specification and in the claims, unless clearly

indicated to the contrary, should be understood to include the plural referents. Claims or descriptions that include "or" between one or more members of a group are considered satisfied if one, more than one, or all of the group members are present in, employed in, or otherwise relevant to a given product or process unless indicated to the contrary or otherwise evident from the context. The invention includes embodiments in which exactly one member of the group is present in, employed in, or otherwise relevant to a given product or process. The invention also includes embodiments in which more than one, or all of the group members are present in, employed in, or otherwise relevant to a given product or process. Furthermore, it is to be understood that the invention encompasses all variations, combinations, and permutations in which one or more limitations, elements, clauses, descriptive terms, etc., from one or more of the listed claims is introduced into another claim dependent on the same base claim (or, as relevant, any other claim) unless otherwise indicated or unless it would be evident to one of ordinary skill in the art that a contradiction or inconsistency would arise. Where elements are presented as lists, e.g., in Markush group or similar format, it is to be understood that each subgroup of the elements is also disclosed, and any element(s) can be removed from the group. It should it be understood that, in general, where the invention, or aspects of the invention, is/are referred to as comprising particular elements, features, etc., certain embodiments of the invention or aspects of the invention consist, or consist essentially of, such elements, features, etc. For purposes of simplicity those embodiments have not in every case been specifically set forth herein. It should also be understood that any embodiment of the invention can be explicitly excluded from the claims, regardless of whether the specific exclusion is recited in the specification. For example, any somatic cell, e.g., fibroblast, any agent, any somatic cell type, any β-cell reprogramming agent, etc., may be excluded.

[00352] Where ranges are given herein, the invention includes embodiments in which the endpoints are included, embodiments in which both endpoints are excluded, and embodiments in which one endpoint is included and the other is excluded. It should be assumed that both endpoints are included unless indicated otherwise. Furthermore, it is to be understood that unless otherwise indicated or otherwise evident from the context and understanding of one of ordinary skill in the art, values that are expressed as ranges can assume any specific value or subrange within the stated ranges in different embodiments of the invention, to the tenth of the unit of the lower limit of the range, unless the context clearly dictates otherwise. It is also understood that where a series of numerical values is stated herein, the invention includes embodiments that relate analogously to any intervening value or range defined by any two values in the series, and that the lowest value may be taken as a minimum and the greatest value may be taken as a maximum. Numerical values, as used herein, include values expressed as percentages. For any embodiment of the invention in which a numerical value is prefaced by "about" or "approximately", the invention includes an embodiment in which the exact value is recited. For any embodiment of the invention in which a numerical value is not prefaced by "about" or "approximately", the invention includes an embodiment in which the value is prefaced by "about" or "approximately". "Approximately" or "about" is intended to encompass numbers that fall within a range of ±10% of a number, in some embodiments within ±5% of a number, in some embodiments within ±1%, in some embodiments within ±0.5% of a number, in some embodiments within ±0.1% of a number unless otherwise stated or otherwise evident from the context (except where such number would impermissibly exceed 100% of a possible value).

[00353] Certain claims are presented in dependent form for the sake of convenience, but Applicant reserves the right to rewrite any dependent claim in independent form to include the limitations of the independent claim and any other claim(s) on which such claim depends, and such rewritten claim is to be considered equivalent in all respects to the dependent claim in whatever form it is in (either amended or unamended) prior to being rewritten in independent format. It should also be understood that, unless clearly indicated to the contrary, in any methods claimed herein that include more than one act, the order of the acts of the method is not necessarily limited to the order in which the acts of the method are recited, but the invention includes embodiments in which the order is so limited.

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Claims

What is claimed:

1. A method for transdifferentiation of a first somatic cell into a motor neuron, the method comprising increasing the protein expression of at least three motor-neuron inducing (MN-inducing) factors selected from the group consisting of: Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl, wherein the motor neuron exhibits at least two characteristics of an endogenous motor neuron.

2. The method of claim 1 , wherein the three motor-neuron inducing factors are Lhx2, Ascll and one motor neuron inducing factor selected from the group consisting of: Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroD.

3. The method of any of claims 1 to 3, wherein the three motor-neuron inducing factors are Mytll, Brn2 and one motor neuron inducing factor selected from the group consisting of: Lhx3, Ascl, Ml, Hb9, Ngn2 or NeuroD.

4. The method of any of claims 1 to 3, wherein the three motor-neuron inducing factors do not include Mytll or Brn2.

5. The method of any of claims 1 to 4, wherein the motor neuron inducing factors does not comprise miR-124.

6. The method of any of claims 1 to 5, wherein the motor neuron inducing factors does not comprise Ml.

7. The method of any of claims 1 to 5, wherein the somatic cell is a fibroblast cell.

8. The method of any of claims 1 to 6, wherein a characteristic of the motor neuron is expression of at least two motor neuron specific genes selected from the group consisting of: 2-tubulins, Map2, synapsins, synaptophysin, synaptotagmins, NeuroD, Ml, cholineacetyltransferase (ChAT).

9. The method of claim 8, wherein the β2- tubulin is selected from Tubb2a and Tubb2b.

10. The method of claim 8, wherein the synapsins is selected from Synl and Syn2.

11. The method of claim 8, wherein the synaptotagmins are selected from: Sytl, Syt4, Sytl3, Syt 16.

12. The method of claim 8, wherein the ChAT is vesicular ChAT.

13. The method of any of claims 1 to 12, wherein a characteristic of the motor neuron is expression of a decreased level of a fibroblast gene selected from the group of: Snail 1, thyl and Fspl, by a statistically significant level as compared to the somatic cell from which the motor neuron was derived.

14. The method of any of claims 1 to 13, wherein a characteristic of the motor neuron is a motor neuron morphology, comprising a cell body with axonal projections which form functional synaptic junctions with muscle cells.

15. The method of any of claims 1 to 14, wherein a characteristic of the motor neuron is an average resting potential of below -50mV.

16. The method of claims 15, wherein the motor neuron has an average resting potential of between - 65mV and -50mV.

17. The method of any of claims 1 to 16, wherein a characteristic of the motor neuron is a functional characteristic selected from the group consisting of: ability to fire action potentials, produce an outward current in response to glycine, GABA or kainate, or produce an inward current in response to glutamate.

18. The method of any of claims 1 to 17, wherein the protein expression of a MN-inducing factor is increased by contacting the somatic cell with an agent which increases the expression of the MN- inducing factor.

19. The method of claim 18, wherein the agent is selected from the group consisting of: a nucleotide sequence, a protein, an aptamer, a small molecule, a ribosome, a RNAi agent, a peptide -nucleic acid (PNA), or analogues or variants thereof.

20. The method of any of claims 1 to 19, wherein protein expression is increased by introducing at least one nucleic acid sequence encoding a MN-inducing factor protein selected from Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl, or encoding a functional fragment thereof, in the somatic cell.

21. The method of any of claims 1 to 20, wherein the protein expression of Lhx3 is increased by

introducing a nucleic acid sequence encoding Lhx3 polypeptide comprising SEQ ID NO: 1 or SEQ ID NO: 2 a functional fragment thereof.

22. The method of any of claims 1 to 20, wherein the protein expression of Ascll is increased by

introducing a nucleic acid sequence encoding Ascll polypeptide comprising SEQ ID NO: 3 or SEQ ID NO: 4 or a functional fragment thereof.

23. The method of any of claims 1 to 20, wherein the protein expression of Brn2 is increased by

introducing a nucleic acid sequence encoding Brn2 polypeptide comprising SEQ ID NO: 5 or SEQ ID NO: 6 or a functional fragment thereof.

24. The method of any of claims 1 to 20, wherein the protein expression of Mytll is increased by

introducing a nucleic acid sequence encoding Mytll polypeptide comprising SEQ ID NO: 7 or SEQ ID NO: 8 or a functional fragment thereof.

25. The method of any of claims 1 to 20, wherein the protein expression of Isll is increased by

introducing a nucleic acid sequence encoding Isll polypeptide comprising SEQ ID NO: 9 or SEQ ID NO: 10 or a functional fragment thereof.

26. The method of any of claims 1 to 20, wherein the protein expression of Hb9 is increased by

introducing a nucleic acid sequence encoding Hb9 polypeptide comprising SEQ ID NO: 11 or SEQ ID NO: 12 or a functional fragment thereof.

27. The method of any of claims 1 to 20, wherein the protein expression of Ngn2 is increased by

introducing a nucleic acid sequence encoding Ngn2 polypeptide comprising SEQ ID NO: 13 or SEQ ID NO: 14 or a functional fragment thereof.

28. The method of any of claims 1 to 20, wherein the protein expression of NeuroDl is increased by introducing a nucleic acid sequence encoding NeuroDl polypeptide comprising SEQ ID NO: 15 or SEQ ID NO: 16 or a functional fragment thereof.

29. The method of any of claims 1 to 28, wherein the nucleic acid sequence is in a vector.

30. The method of any of claims 1 to 29, wherein the vector is a viral vector or a non-viral vector.

31. The method of claim 30, wherein the viral vector comprises a genome which does not integrate into the somatic cell genome.

32. The method of any of claims 1 to 31 , wherein the somatic cell is in vitro.

33. The method of any of claims 1 to 31, wherein the somatic cell is ex vivo.

34. The method of any of claims 1 to 33, wherein the somatic cell is a mammalian somatic cell.

35. The method of claim 34, wherein the mammalian somatic cell is a human somatic cell.

36. The method of any of claims 1 to 35, wherein the somatic cell is obtained from a subject.

37. The method of claim 36, wherein the subject is a human subject.

38. The method of claim 37, wherein the subject has, or is at risk of developing a motor neuron disease or disorder.

39. The method of claim 38, wherein the motor neuron disease or disorder is selected from amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy (SMA) or associated diseases thereof.

40. The method of any of claims 1 to 39, wherein the motor neuron is a motor neuron-like cell.

41. An isolated population of motor neurons obtained from a population of somatic cells by a process of increasing the protein expression of at least three motor-neuron inducing (MN-inducing) factors selected from the group consisting of: Lhx3, Ascll, Brn2, Mytll, Ml, Hb9, Ngn2 or NeuroDl, or a functional fragment thereof, in a somatic cell.

42. The isolated population of motor neurons of claim 41, wherein the motor neuron exhibits at least two characteristics of an endogenous motor neuron.

43. The isolated population of motor neurons of claim 41, wherein the somatic cell is a fibroblast.

44. The isolated population of motor neurons of any of claims 41 to 43, produced by the method of any of claims 1 to 40.

45. The isolated population of motor neurons of any of claims 41 to 44, wherein the somatic cell is a mammalian somatic cell.

46. The isolated population of motor neurons of any of claims 41 to 45, wherein the mammalian somatic cell is a human somatic cell.

47. The isolated population of motor neurons of any of claims 41 to 46, wherein the human somatic cell is obtained from a subject at risk or, or having a motor neuron disease or disorder.

48. The isolated population of motor neurons of claim 47, wherein the motor neuron disease or disorder is selected from amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy (SMA) or associated diseases thereof.

49. A method for treating a subject with a motor neuron disease or disorder, comprising administering a composition comprising an isolated population of motor neurons according to claims 41 to 48.

50. The method of claim 49, wherein the motor neurons are produced from a somatic cell obtained from the same subject as the composition is administered to.

51. The method of claim 49, wherein motor neuron disease or disorder is selected from amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy (SMA) or associated diseases thereof.

52. Use of an isolated population of motor neurons according to claims 41 to 48 for administering to a subject in need thereof.

53. An assay comprising an isolated population of motor neurons according to any of claims 41 to 48.

54. The assay of claim 53 for use in identifying one or more test agents which promote or inhibit motor neuron survival.

55. The assay of claim 53, for use in identifying one or more test agents which promote the direct transdifferentiation of a somatic cell into a motor neuron.

56. A kit comprising at least three of the following agents:

a. a nucleic acid sequence encoding a Lhx3 polypeptide or a functional fragment thereof, b. a nucleic acid sequence encoding a Ascll polypeptide or a functional fragment thereof, c. a nucleic acid sequence encoding a Brn2 polypeptide or a functional fragment thereof, d. a nucleic acid sequence encoding a My til polypeptide or a functional fragment thereof, e. a nucleic acid sequence encoding a Isll polypeptide or a functional fragment thereof, f. a nucleic acid sequence encoding a Hb9 polypeptide or a functional fragment thereof, g. a nucleic acid sequence encoding a Ngn2 polypeptide or a functional fragment thereof, and

h. a nucleic acid sequence encoding a NeuroDl polypeptide or a functional fragment thereof.

57. The kit of claim 56, further comprising instructions for direct transdifferentiation of a somatic cell into a motor neuron comprising at least two characteristics of an endogenous motor neuron.

58. A composition comprising at least one somatic cell and at least three motor-neuron inducing (MN- inducing) factors selected from the group consisting of: Lhx3, Ascll, Brn2, Mytll, Isll, Hb9, Ngn2 or NeuroDl, or a functional fragment thereof.

59. The composition of claim 58, wherein the somatic cell is a fibroblast cell.

60. The composition of claim 58, further comprising a motor neuron exhibiting at least two

characteristics of an endogenous motor neuron.

61. A culture comprising a motor neuron and muscle cells.

62. The culture of claim 61, wherein the motor neurons are human motor neurons.

63. The culture of any of claims 61 to 62, wherein the motor neurons are produced according to any of claims 1 to 48.

64. The culture of any of claims 61 to 63, wherein the muscle cells are myotubules.